| Dba Premier Primary Care | |
|
150 Brett Chase Suite B Paducah KY 42003-5706 | |
| (270) 554-4820 | |
| (270) 448-0300 |
| Full Name | Dba Premier Primary Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 150 Brett Chase, Paducah, Kentucky |
| Authorized Official Name and Position | Lee Tolar Meals (OWNER/MEMBER TAX MATTERS) |
| Authorized Official Contact | 2705544820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dba Premier Primary Care 150 Brett Chase Suite B Paducah KY 42003-5706 Ph: (270) 554-4820 | Dba Premier Primary Care 150 Brett Chase Suite B Paducah KY 42003-5706 Ph: (270) 554-4820 |
| NPI Number | 1144610213 |
|---|---|
| Provider Enumeration Date | 01/28/2015 |
| Last Update Date | 09/17/2015 |
| Medicare PECOS PAC ID | 1052615408 |
|---|---|
| Medicare Enrollment ID | O20160205001029 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144610213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Lee Tolar Meals |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578622379 PECOS PAC ID: 5698665438 Enrollment ID: I20110104001212 |
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