Provider Demographics
NPI:1538274196
Name:THORNTON, RICHARD SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SCOTT
Last Name:THORNTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:R
Other - Middle Name:SCOTT
Other - Last Name:THORNTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1650 HUNTINGDON PIKE
Mailing Address - Street 2:MOB 250
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046
Mailing Address - Country:US
Mailing Address - Phone:215-947-5688
Mailing Address - Fax:215-947-9422
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:MOB 250
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046
Practice Address - Country:US
Practice Address - Phone:215-947-5688
Practice Address - Fax:215-947-9422
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMC024698E207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
094826Medicare ID - Type Unspecified
C29730Medicare UPIN