1245207596 NPI number — DR. DAVID R HESS JR. MD

Table of content: DR. DAVID R HESS JR. MD (NPI 1245207596)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245207596 NPI number — DR. DAVID R HESS JR. MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HESS
Provider First Name:
DAVID
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1245207596
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
785 5TH AVENUE
Provider Second Line Business Mailing Address:
SUITE 3
Provider Business Mailing Address City Name:
CHAMBERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17201-4232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-263-9555
Provider Business Mailing Address Fax Number:
717-217-4217

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1964 BUCHANAN TR E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHADY GROVE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-597-7131
Provider Business Practice Location Address Fax Number:
717-597-0898
Provider Enumeration Date:
03/07/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  MD007487E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1412875 . This is a "AETNA HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5735681 . This is a "FIRST HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007428690001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 25-1716306 . This is a "DEVON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 25-1716306 . This is a "HEALTHNET/TRICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 25-1716306 . This is a "INFORMED" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 25-1716306 . This is a "INTERGROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 867633 . This is a "MEDICARE GROUP #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 25-1716306 . This is a "MULTIPLAN/PHCS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: MD007487E . This is a "LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 120420414 . This is a "DEPT OF LABOR" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50064070 . This is a "CAPITAL BLUECROSS (SHADY GROVE)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50086065 . This is a "CAPITAL BLUECROSS (TUSCARORA)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: G920-0051/25RXCU . This is a "CAREFIRST" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: HE019179 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 196177 . This is a "UNISON (SHADY GROVE)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7706807 . This is a "AETNA NON-HMO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 25-1716306 . This is a "SOUTH CENTRAL PREFERRED" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00390473 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 260784 . This is a "UNISON (TUSCARORA)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".