1225977010 NPI number — DUBOIS REGIONAL MEDICAL CENTER

Table of content: PIERCE JULIAN DOERR LMT (NPI 1487247300)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225977010 NPI number — DUBOIS REGIONAL MEDICAL CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DUBOIS REGIONAL MEDICAL CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

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 Information

NPI Number:
1225977010
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 MEADOW LN STE 4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DU BOIS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15801-2460
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 MEADOW LN STE 4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DU BOIS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15801-2460
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-375-0600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/26/2026

Additional Information

Authorized Official

Authorized Official Last Name:
STRISHOCK
Authorized Official First Name:
JOURDAN
Authorized Official Middle Name:
Authorized Official Title or Position:
COMPLIANCE OFFICER
Authorized Official Telephone Number:
814-375-6160

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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