Provider Demographics
NPI:1295704955
Name:WAYNE FAMILY PHYSICIANS
Entity type:Organization
Organization Name:WAYNE FAMILY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:JARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-687-3670
Mailing Address - Street 1:400 E LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-4319
Mailing Address - Country:US
Mailing Address - Phone:610-687-3670
Mailing Address - Fax:610-687-1074
Practice Address - Street 1:400 E LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-4319
Practice Address - Country:US
Practice Address - Phone:610-687-3670
Practice Address - Fax:610-687-1074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA918238OtherBLUE SHIELD
PA054308Medicare ID - Type Unspecified