Provider Demographics
NPI:1548256134
Name:MINGLE, JOHN JOSEPH (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:MINGLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-721-8789
Mailing Address - Fax:717-715-1360
Practice Address - Street 1:207 W FULTON ST
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-1902
Practice Address - Country:US
Practice Address - Phone:717-721-8789
Practice Address - Fax:717-715-1360
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4267332084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA201546OtherUNISON-WMG
PA210714OtherJOHNS HOPKINS
PA1545091OtherGATEWAY-WMG
PA2162148OtherMAMSI-WMG
PA7761783OtherAETNA
PA20059720OtherAMERIHEALTH MERCY-WMG
PA3944OtherGEISINGER
PA101469120Medicaid
PA1741947OtherHIGHMARK BLUE SHIELD
MD894203OtherCAREFIRST MD BCBS
PA2407873000OtherAMERIHEALTH 65 PA
PA50065564OtherCAPITAL BLUE CROSS-WMG
PA092455FLTMedicare PIN
PA2162148OtherMAMSI-WMG
PA1545091OtherGATEWAY-WMG