Provider Demographics
NPI:1871545871
Name:GREENGATE ORTHOPAEDIC GROUP P.C.
Entity type:Organization
Organization Name:GREENGATE ORTHOPAEDIC GROUP P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:MACPHAIL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:724-837-9113
Mailing Address - Street 1:4000 HEMPFIELD PLAZA BLVD STE 963
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-1485
Mailing Address - Country:US
Mailing Address - Phone:724-837-9113
Mailing Address - Fax:724-837-9140
Practice Address - Street 1:4000 HEMPFIELD PLAZA BLVD STE 963
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1485
Practice Address - Country:US
Practice Address - Phone:724-837-9113
Practice Address - Fax:724-837-9140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD021853E207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA188674Medicare PIN