| Appalachian Primary Care, Pllc | |
|
107 Haywood Park Dr Clyde NC 28721-4405 | |
| (828) 237-8001 | |
| (828) 237-8002 |
| Full Name | Appalachian Primary Care, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 107 Haywood Park Dr, Clyde, North Carolina |
| Authorized Official Name and Position | Travis M Hecker (OWNER/CEO) |
| Authorized Official Contact | 8282378001 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Appalachian Primary Care, Pllc 107 Haywood Park Dr Clyde NC 28721-4405 Ph: (828) 237-8001 | Appalachian Primary Care, Pllc 107 Haywood Park Dr Clyde NC 28721-4405 Ph: (828) 237-8001 |
| NPI Number | 1184349987 |
|---|---|
| Provider Enumeration Date | 10/05/2022 |
| Last Update Date | 10/10/2022 |
| Medicare PECOS PAC ID | 6204204944 |
|---|---|
| Medicare Enrollment ID | O20221130001269 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184349987 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| Provider Name | Glen Robert Liesegang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174584866 PECOS PAC ID: 8426181934 Enrollment ID: I20100804000973 |
| Provider Name | Travis M Hecker |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1699979518 PECOS PAC ID: 1658520911 Enrollment ID: I20151029002984 |
| Provider Name | Laurie Mclean Shirey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215489968 PECOS PAC ID: 7113201583 Enrollment ID: I20170302001360 |
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