| Organization Name: | SUSQUEHANNA PHYSICIAN SERVICES |
| NPI Number: | 1013963370 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MELISSA DAVIS (VP/COO) |
| Mailing Address: | 1705 Warren Ave Suite 303 Williamsport |
| State: | PA US |
| Postal Code: | 177012665 |
| Phone Number: | 5703268500 |
| Fax Number: | 5703268049 |
| NPI Enumeration Date: | 05/26/2006 |
| NPI Last Update Date: | 10/20/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VX0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Obstetrics |
| Taxonomy Definition: | |