Provider Demographics
NPI:1831227404
Name:THE MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP
Entity type:Organization
Organization Name:THE MILTON S HERSHEY MEDICAL CENTER PHYSICIANS GROUP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKENNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-531-3979
Mailing Address - Street 1:PO BOX 858
Mailing Address - Street 2:MC A410
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-0858
Mailing Address - Country:US
Mailing Address - Phone:717-531-1159
Mailing Address - Fax:
Practice Address - Street 1:101 ERFORD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-1802
Practice Address - Country:US
Practice Address - Phone:717-761-8900
Practice Address - Fax:717-761-1320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA135101207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA10076500730069Medicaid
PA10076500730069Medicaid