Provider Demographics
NPI:1770544702
Name:HEBERLING, THOMAS P (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:HEBERLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 215
Mailing Address - Street 2:210 THIRD STREET
Mailing Address - City:MOUNT GRETNA
Mailing Address - State:PA
Mailing Address - Zip Code:17064-0215
Mailing Address - Country:US
Mailing Address - Phone:717-964-2327
Mailing Address - Fax:
Practice Address - Street 1:210 3RD ST
Practice Address - Street 2:
Practice Address - City:MOUNT GRETNA
Practice Address - State:PA
Practice Address - Zip Code:17064-6048
Practice Address - Country:US
Practice Address - Phone:717-964-2327
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD014021E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01562902OtherCAPITAL BLUE CROSS
PA0011233640001Medicaid
PA108432OtherHIGHMARK BLUE SHIELD
PA108432KAGMedicare PIN
PA0011233640001Medicaid
B36743Medicare UPIN