1548256134 NPI number — JOHN JOSEPH MINGLE M.D.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548256134 NPI number — JOHN JOSEPH MINGLE M.D.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MINGLE

Provider First Name:

JOHN

Provider Middle Name:

JOSEPH

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

M.D.

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1548256134

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

11/04/2021

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

3421 CONCORD RD

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

YORK

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

17402-9001

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

717-721-8789

Provider Business Mailing Address Fax Number:

717-715-1360

Provider First Line Business Practice Location Address:

207 W FULTON ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

EPHRATA

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

17522-1902

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

717-721-8789

Provider Business Practice Location Address Fax Number:

717-715-1360

Provider Enumeration Date:

09/20/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 2084N0400X , with the licence number:  MD426733 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 201546 . This is a "UNISON-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 210714 . This is a "JOHNS HOPKINS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 1545091 . This is a "GATEWAY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 2162148 . This is a "MAMSI-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 7761783 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 20059720 . This is a "AMERIHEALTH MERCY-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 3944 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 101469120 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 1741947 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 894203 . This is a "CAREFIRST MD BCBS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
• Identifier: 2407873000 . This is a "AMERIHEALTH 65 PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 50065564 . This is a "CAPITAL BLUE CROSS-WMG" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".