| Family Medicine Associates Of North Stafford | |
|
2761 Jefferson Davis Hwy Ste 101 Stafford VA 22554-8330 | |
| (909) 281-4720 | |
| Not Available |
| Full Name | Family Medicine Associates Of North Stafford |
|---|---|
| Speciality | Family Medicine |
| Location | 2761 Jefferson Davis Hwy Ste 101, Stafford, Virginia |
| Authorized Official Name and Position | Yolanda Reid (PRESIDENT) |
| Authorized Official Contact | 9092814720 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Associates Of North Stafford 2761 Jefferson Davis Hwy Ste 101 Stafford VA 22554-8330 Ph: (540) 786-2100 | Family Medicine Associates Of North Stafford 2761 Jefferson Davis Hwy Ste 101 Stafford VA 22554-8330 Ph: (909) 281-4720 |
| NPI Number | 1447893953 |
|---|---|
| Provider Enumeration Date | 10/28/2019 |
| Last Update Date | 01/23/2020 |
| Medicare PECOS PAC ID | 6800222324 |
|---|---|
| Medicare Enrollment ID | O20200131001965 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447893953 | NPI | - | NPPES |
| 010211689 | Medicaid | VA | |
| 541595397 | Other | VA | TRICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Yolanda G Reid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184690935 PECOS PAC ID: 1850310681 Enrollment ID: I20051122000114 |
| Provider Name | Taylor Brockman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245883693 PECOS PAC ID: 3173955887 Enrollment ID: I20191119001665 |
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