| F A Mcgowan & R D Lee | |
|
115 Clifton Ave Collingdale PA 19023-3809 | |
| (610) 586-1919 | |
| (610) 586-6947 |
| Full Name | F A Mcgowan & R D Lee |
|---|---|
| Speciality | Family Medicine |
| Location | 115 Clifton Ave, Collingdale, Pennsylvania |
| Authorized Official Name and Position | Reginald Donald Lee (PHYSICIAN) |
| Authorized Official Contact | 6105861919 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| F A Mcgowan & R D Lee 115 Clifton Ave Collingdale PA 19023-3809 Ph: (610) 586-1919 | F A Mcgowan & R D Lee 115 Clifton Ave Collingdale PA 19023-3809 Ph: (610) 586-1919 |
| NPI Number | 1902964455 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0143207340 |
|---|---|
| Medicare Enrollment ID | O20040706000997 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902964455 | NPI | - | NPPES |
| 0307511001 | Other | PA | INDEPENDENCE BLUE CROSS |
| D 19240 | Other | PA | INTER-COUNTY HEALTH HOS |
| 098616 | Other | PA | AETNA U S HEALTHCARE |
| 1141676 | Medicaid | PA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS006159-L (Pennsylvania) | Primary |
| Provider Name | Reginald D Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124031877 PECOS PAC ID: 7810141231 Enrollment ID: I20130211000508 |
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