Provider Demographics
NPI:1457706996
Name:WITT, PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:
Last Name:WITT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:PAUL
Other - Middle Name:
Other - Last Name:WITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO, PLLC
Mailing Address - Street 1:59 E CAREY ST
Mailing Address - Street 2:
Mailing Address - City:PLAINS
Mailing Address - State:PA
Mailing Address - Zip Code:18705-2007
Mailing Address - Country:US
Mailing Address - Phone:570-690-3707
Mailing Address - Fax:570-824-4090
Practice Address - Street 1:59 E CAREY ST
Practice Address - Street 2:
Practice Address - City:PLAINS
Practice Address - State:PA
Practice Address - Zip Code:18705-2007
Practice Address - Country:US
Practice Address - Phone:570-823-7643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-03
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS020156208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist