Provider Demographics
NPI:1134198666
Name:FAMILY PHYSICIAN ASSOCIATES, INC.
Entity type:Organization
Organization Name:FAMILY PHYSICIAN ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-557-6987
Mailing Address - Street 1:507 TIRE HILL ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JOHNSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15905
Mailing Address - Country:US
Mailing Address - Phone:814-467-4055
Mailing Address - Fax:814-262-8161
Practice Address - Street 1:1900 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070-1127
Practice Address - Country:US
Practice Address - Phone:717-774-7041
Practice Address - Fax:717-774-3213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006372460001Medicaid
PA154151Medicare PIN
PA1134198666OtherNATIONAL PROVIDER IDENTIF
PA2321979301OtherTAX ID NUMBER