Provider Demographics
NPI:1528145968
Name:DAUL F. REMICK, DO
Entity type:Organization
Organization Name:DAUL F. REMICK, DO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:F
Authorized Official - Last Name:REMICK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-346-8417
Mailing Address - Street 1:1721 N MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18508-1995
Mailing Address - Country:US
Mailing Address - Phone:570-346-8417
Mailing Address - Fax:570-344-3778
Practice Address - Street 1:1721 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:SCRANTON
Practice Address - State:PA
Practice Address - Zip Code:18508-1995
Practice Address - Country:US
Practice Address - Phone:570-346-8417
Practice Address - Fax:570-344-3778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS004041L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
B40442Medicare UPIN
PA164317Medicare ID - Type Unspecified