Doctor Name: | DR. KEVIN ALLAN MISHOCK |
NPI Number: | 1063432896 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | OS011815L |
Business Practice Address: | 1800 E Park Ave Mount Nittany Medical Center State College, PA - 168036701 |
Business Phone Number: | 8142346110 |
Business Fax Number: | |
Mailing Address: | 617 Purdue Mountain Rd, BELLEFONTE |
State: | PA |
Postal Code: | 168238931 |
Phone Number: | 8143538922 |
Fax Number: | |
NPI Enumeration Date: | 07/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207PE0004X |
License Number: | OS011815L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Emergency Medicine |
Taxonomy Specialization: | Emergency Medical Services |
Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |