Provider Demographics
NPI:1801368097
Name:KEYSTONE ORTHOPAEDIC SPECIALISTS LLC
Entity Type:Organization
Organization Name:KEYSTONE ORTHOPAEDIC SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:FEEHRER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-779-2663
Mailing Address - Street 1:11 FAIRLANE RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-9567
Mailing Address - Country:US
Mailing Address - Phone:610-779-2663
Mailing Address - Fax:610-779-3367
Practice Address - Street 1:11 FAIRLANE RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19606-9567
Practice Address - Country:US
Practice Address - Phone:610-779-2663
Practice Address - Fax:610-779-3367
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEYSTONE ORTHOPAEDIC SPECIALISTS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty