Provider Demographics
NPI:1487617155
Name:LOPATOFSKY, DAVID JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JAMES
Last Name:LOPATOFSKY
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 1:1201 GRAMPIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1900
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 PINE ST STE 200
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-6549
Practice Address - Country:US
Practice Address - Phone:570-326-2447
Practice Address - Fax:570-326-1247
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042307L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001794OtherFIRST PRIORITY HEALTH
PA0012142350003Medicaid
PA555309OtherAETNA
PA0012142350008Medicaid
PAE58662OtherHEALTHAMERICA
PA1554159OtherUNITEDHEALTHCARE
PA630211OtherHIGHMARK BLUE SHIELD
PA630211OtherHIGHMARK BLUE SHIELD
PA0012142350003Medicaid
PAE58662OtherHEALTHAMERICA