Provider Demographics
NPI:1154400059
Name:OATMAN, ABBEY M
Entity type:Individual
Prefix:
First Name:ABBEY
Middle Name:M
Last Name:OATMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ABBEY
Other - Middle Name:M
Other - Last Name:EZTWEILER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:700 QUINCY AVE
Mailing Address - Street 2:ED
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18510-1724
Mailing Address - Country:US
Mailing Address - Phone:570-340-2100
Mailing Address - Fax:570-558-7936
Practice Address - Street 1:700 QUINCY AVE
Practice Address - Street 2:ED
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-1724
Practice Address - Country:US
Practice Address - Phone:570-340-2100
Practice Address - Fax:570-558-7936
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA052737363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50064837OtherCAPITAL BC
PA50064837OtherCAPITAL BC