Provider Demographics
NPI:1912965534
Name:MUIR OBGYN ASSOCIATES PC
Entity Type:Organization
Organization Name:MUIR OBGYN ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:MUIR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-459-6000
Mailing Address - Street 1:601 ALTER STREET
Mailing Address - Street 2:
Mailing Address - City:HAZLETON
Mailing Address - State:PA
Mailing Address - Zip Code:18201
Mailing Address - Country:US
Mailing Address - Phone:570-459-6000
Mailing Address - Fax:570-459-9768
Practice Address - Street 1:601 ALTER STREET
Practice Address - Street 2:
Practice Address - City:HAZLETON
Practice Address - State:PA
Practice Address - Zip Code:18201
Practice Address - Country:US
Practice Address - Phone:570-459-6000
Practice Address - Fax:570-459-9768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01459229Medicaid
078577OtherHMO
PA01459229Medicaid