Provider Demographics
NPI:1912449034
Name:HR PHYSICIAN SERVICES
Entity Type:Organization
Organization Name:HR PHYSICIAN SERVICES
Other - Org Name:INTEGRATIVE WOMEN'S HEALTH AND GYNECOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE, VICE PRESIDENT FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:R
Authorized Official - Last Name:WAGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-856-1114
Mailing Address - Street 1:12265 TOWNSEND RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-1201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:385 OXFORD VALLEY RD
Practice Address - Street 2:SUITE 310
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-7700
Practice Address - Country:US
Practice Address - Phone:215-544-5696
Practice Address - Fax:215-321-0476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD047631L207VG0400X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty