Provider Demographics
NPI:1912967811
Name:JAMES, GEOFFREY MINTO (MD)
Entity Type:Individual
Prefix:DR
First Name:GEOFFREY
Middle Name:MINTO
Last Name:JAMES
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 1:409 S 2ND ST
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1612
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2140 FISHER RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-5122
Practice Address - Country:US
Practice Address - Phone:717-766-1795
Practice Address - Fax:717-697-6575
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022884E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000800354Medicaid
080148691OtherRR MEDICARE
PA151703Medicare PIN
D71310Medicare UPIN