Provider Demographics
NPI:1295952828
Name:ROBERT C MAGLEY, MD, PC
Entity type:Organization
Organization Name:ROBERT C MAGLEY, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:C
Authorized Official - Last Name:MAGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-472-7320
Mailing Address - Street 1:1100 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:EBENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15931-1706
Mailing Address - Country:US
Mailing Address - Phone:814-472-7320
Mailing Address - Fax:814-472-5666
Practice Address - Street 1:1100 W HIGH ST
Practice Address - Street 2:
Practice Address - City:EBENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15931-1706
Practice Address - Country:US
Practice Address - Phone:814-472-7320
Practice Address - Fax:814-472-5666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD025734L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0050032OtherUMWA
PA0011888410001Medicaid
PAMA012312Medicare ID - Type Unspecified
PA0050032OtherUMWA