Provider Demographics
NPI:1932215530
Name:STRATTON, ROBERT GREGORY JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GREGORY
Last Name:STRATTON
Suffix:JR
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 1:13 RIDGE CREST DR
Mailing Address - Street 2:
Mailing Address - City:FLEETWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19522-8876
Mailing Address - Country:US
Mailing Address - Phone:484-269-0866
Mailing Address - Fax:
Practice Address - Street 1:9 DAVES WAY
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:PA
Practice Address - Zip Code:19526
Practice Address - Country:US
Practice Address - Phone:610-628-7201
Practice Address - Fax:610-628-7211
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH12517207Q00000X
PAMD034026E207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1284919Medicaid
PAD71844Medicare UPIN
PA583512Medicare ID - Type Unspecified