| Anglyn Family Medical Center, Llc | |
|
55 Sims St Mcdonough GA 30253-2320 | |
| (770) 957-3922 | |
| (770) 957-5477 |
| Full Name | Anglyn Family Medical Center, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 55 Sims St, Mcdonough, Georgia |
| Authorized Official Name and Position | Vicki R Anglyn (OFFICE MANAGER) |
| Authorized Official Contact | 7709573922 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Anglyn Family Medical Center, Llc 55 Sims St Mcdonough GA 30253-2320 Ph: (770) 957-3922 | Anglyn Family Medical Center, Llc 55 Sims St Mcdonough GA 30253-2320 Ph: (770) 957-3922 |
| NPI Number | 1043381361 |
|---|---|
| Provider Enumeration Date | 11/10/2006 |
| Last Update Date | 07/13/2011 |
| Medicare PECOS PAC ID | 8921157942 |
|---|---|
| Medicare Enrollment ID | O20090522000133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043381361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Derrell W Anglyn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952472375 PECOS PAC ID: 5092864017 Enrollment ID: I20100916000878 |
| Provider Name | Adam Anglyn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215321971 PECOS PAC ID: 6406148295 Enrollment ID: I20180813003144 |
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