Provider Demographics
NPI:1649263914
Name:STRUNK, GEORGE A JR (CRNA)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:A
Last Name:STRUNK
Suffix:JR
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 NORTH BROAD STREET EXT.
Mailing Address - Street 2:WOLF CREEK MEDICAL ASSOCIATES
Mailing Address - City:GROVE CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16127-4604
Mailing Address - Country:US
Mailing Address - Phone:724-450-7263
Mailing Address - Fax:724-450-7103
Practice Address - Street 1:631 NORTH BROAD STREET EXT
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:PA
Practice Address - Zip Code:16127-4603
Practice Address - Country:US
Practice Address - Phone:724-450-7263
Practice Address - Fax:724-450-7103
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN201596L367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS62809Medicare UPIN