| Organization Name: | FORNANCE PHYSICIAN SERVICES, INC. |
| NPI Number: | 1760423230 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KAREN ROBBINS (REIMBURSEMENT/CREDENTIALING MANAGER) |
| Mailing Address: | 342 W Germantown Pike Suite 200 East Norriton |
| State: | PA US |
| Postal Code: | 194034260 |
| Phone Number: | 6102791500 |
| Fax Number: | 6102786065 |
| NPI Enumeration Date: | 06/08/2006 |
| NPI Last Update Date: | 03/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |