Basic Information
| Provider Information | |||||||||
| NPI: | 1891792719 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINTZ | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | A | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 118 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171041677 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 S FRONT ST | ||||||||
| Address2: | |||||||||
| City: | HARRISBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 171012010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177823380 | ||||||||
| FaxNumber: | 7177825716 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 11/11/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 0728 | SC | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | OS009480L | PA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 001371524 | 01 | PA | HIGHMARK BS | OTHER | 0017751670006 | 05 | PA | MEDICAID | 1514929 | 01 | PA | GATEWAY | OTHER | 71502 | 01 | PA | GEISINGER | OTHER | 001775167 | 05 | PA | MEDICAID | 0017751670005 | 05 | PA | MEDICAID | 0017751670004 | 05 | PA | MEDICAID | 50071004 | 01 | PA | CAPITAL BC | OTHER | T00452 | 05 | SC | MEDICAID | 141303 | 01 | PA | UNISON | OTHER |