Provider Demographics
NPI:1912131848
Name:DPA MEDICAL SERVICES INC
Entity Type:Organization
Organization Name:DPA MEDICAL SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:P
Authorized Official - Last Name:ANTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-238-3560
Mailing Address - Street 1:621 WEST MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LIGONIER
Mailing Address - State:PA
Mailing Address - Zip Code:15658-1017
Mailing Address - Country:US
Mailing Address - Phone:724-238-4103
Mailing Address - Fax:724-238-4107
Practice Address - Street 1:621 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:LIGONIER
Practice Address - State:PA
Practice Address - Zip Code:15658-1017
Practice Address - Country:US
Practice Address - Phone:724-238-4103
Practice Address - Fax:724-238-4107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD050755L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA154629OtherPTAN
PA154629OtherPTAN