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COLON & RECTAL SURGERY, LTD.

>> Colon & Rectal Surgery >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1659390698

Organizational Registrant:
Organization Name:  COLON & RECTAL SURGERY, LTD.
Organization is not Subpart
Authorized Official:  KENNETH J BOYD  PRESIDENT  610--56-53435

Location and contact information for practice:
1088 W BALTIMORE PIKE SUITE 2101 MEDIA, PA 19063-5136 US
Tel: 610-565-3435  Fax: 610-566-1387

Contact information for business:
1088 W BALTIMORE PIKE SUITE 2101 MEDIA, PA 19063-5136 US
Tel: 610-565-3435  Fax: 610-566-1387

Registration Information:
NPI: 1659390698
Entity Type: Organization

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y208C00000XAllopathic & Osteopathic Physicians
Colon & Rectal Surgery

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
INDEPENDENCE BLUE CROSS0091202000PA01
PALMETTO GBACF6297GA01
HIGHMARK BLUE SHIELD190824PA01
KEYSTONE MERCY HEALTH PLA32129PA01
0009855080003PA05




HEALTH CARE JOBS PA - Page 1



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