Provider Demographics
NPI:1548238322
Name:HLAVAC, PHILIP JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:JOSEPH
Last Name:HLAVAC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-703-8888
Mailing Address - Fax:570-703-8512
Practice Address - Street 1:1800 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18510-2369
Practice Address - Country:US
Practice Address - Phone:570-703-8888
Practice Address - Fax:570-703-8512
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2025-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD422501207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001971374Medicaid
PAG91810Medicare UPIN
PA073052Medicare ID - Type Unspecified