Provider Demographics
NPI:1962667899
Name:LEHIGHTON FAMILY MEDICINE, LLC
Entity Type:Organization
Organization Name:LEHIGHTON FAMILY MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:610-377-4181
Mailing Address - Street 1:525 IRON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LEHIGHTON
Mailing Address - State:PA
Mailing Address - Zip Code:18235-1912
Mailing Address - Country:US
Mailing Address - Phone:610-377-4181
Mailing Address - Fax:610-377-4185
Practice Address - Street 1:525 IRON ST
Practice Address - Street 2:SUITE B
Practice Address - City:LEHIGHTON
Practice Address - State:PA
Practice Address - Zip Code:18235-1912
Practice Address - Country:US
Practice Address - Phone:610-377-4181
Practice Address - Fax:610-377-4185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010664L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH39810Medicare UPIN