Provider Demographics
NPI:1447279807
Name:GINSBURG, JOHN LAWRENCE (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:LAWRENCE
Last Name:GINSBURG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9315
Mailing Address - Country:US
Mailing Address - Phone:570-522-4110
Mailing Address - Fax:570-522-4120
Practice Address - Street 1:55 N 5TH ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-1407
Practice Address - Country:US
Practice Address - Phone:570-523-3350
Practice Address - Fax:570-522-0404
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD013692E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAC900OtherHEALTH AMERICA
PA139480OtherBLUE SHIELD
PA80080655OtherRAILROAD MEDICARE
PA19822C3AHOtherGEISINGER
PA0323100OtherKEYSTONE
PA80080655OtherRAILROAD MEDICARE
PA0323100OtherKEYSTONE