Provider Demographics
NPI:1871562819
Name:MOUNTAIN VIEW ORTHOPAEDICS & ASSOCIATES, PC
Entity type:Organization
Organization Name:MOUNTAIN VIEW ORTHOPAEDICS & ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:BOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-455-8544
Mailing Address - Street 1:1201A N CHURCH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HAZLE TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18202-1471
Mailing Address - Country:US
Mailing Address - Phone:570-455-8544
Mailing Address - Fax:570-455-8554
Practice Address - Street 1:1201A N CHURCH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:HAZLE TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18202-1471
Practice Address - Country:US
Practice Address - Phone:570-455-8544
Practice Address - Fax:570-455-8554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2009-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS0091962207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017960400004Medicaid
PA50000123OtherCBC GROUP #
PA1367821OtherBLUESHIELD
PA814625OtherFIRST PRIORITY
PADF5796OtherMC RAILROAD
PA7133212OtherAETNA
PA7133212OtherAETNA
PAH15381Medicare UPIN