Provider Demographics
NPI:1902898208
Name:FLANAGAN, JOHN J (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:FLANAGAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1260 VALLEY FORGE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-2691
Mailing Address - Country:US
Mailing Address - Phone:610-933-2444
Mailing Address - Fax:610-933-8320
Practice Address - Street 1:1260 VALLEY FORGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460-2691
Practice Address - Country:US
Practice Address - Phone:610-933-2444
Practice Address - Fax:610-933-8320
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2013-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD043999L2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA072206Medicare PIN
PAF27186Medicare UPIN
PA722067Medicare ID - Type Unspecified