| Bruce Herrington Md Pc | |
|
116 W Thigpen Ave Ste B Lakeland GA 31635-1011 | |
| (229) 482-2993 | |
| (229) 482-2998 |
| Full Name | Bruce Herrington Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 116 W Thigpen Ave, Lakeland, Georgia |
| Authorized Official Name and Position | Ronald Bruce Herrington (MD) |
| Authorized Official Contact | 2294822993 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bruce Herrington Md Pc 116 W Thigpen Ave Ste B Lakeland GA 31635-1011 Ph: (229) 482-2993 | Bruce Herrington Md Pc 116 W Thigpen Ave Ste B Lakeland GA 31635-1011 Ph: (229) 482-2993 |
| NPI Number | 1013275031 |
|---|---|
| Provider Enumeration Date | 04/27/2012 |
| Last Update Date | 04/27/2012 |
| Medicare PECOS PAC ID | 9436311842 |
|---|---|
| Medicare Enrollment ID | O20120501000697 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013275031 | NPI | - | NPPES |
| 000869701E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 046118 (Georgia) | Primary |
| Provider Name | Ronald B Herrington |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285675488 PECOS PAC ID: 4183675879 Enrollment ID: I20050210000324 |
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