| Giebeig Family Medicine Pa | |
|
5085 West Us Hwy 90 Lake City FL 32055 | |
| (386) 752-0090 | |
| (386) 719-9494 |
| Full Name | Giebeig Family Medicine Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 5085 West Us Hwy 90, Lake City, Florida |
| Authorized Official Name and Position | Peter Wendell Gieberg (MEDICAL DIRECTOR) |
| Authorized Official Contact | 3867520090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Giebeig Family Medicine Pa Po Box 159 Lake City FL 32056-0159 Ph: (386) 752-0090 | Giebeig Family Medicine Pa 5085 West Us Hwy 90 Lake City FL 32055 Ph: (386) 752-0090 |
| NPI Number | 1417011321 |
|---|---|
| Provider Enumeration Date | 12/22/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5092738997 |
|---|---|
| Medicare Enrollment ID | O20060105000935 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417011321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Peter W Giebeig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699838003 PECOS PAC ID: 5496778300 Enrollment ID: I20100831000521 |
| Provider Name | Callie A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710356282 PECOS PAC ID: 8325150626 Enrollment ID: I20160111000841 |
| Provider Name | Melissa Fay Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114439510 PECOS PAC ID: 1557628963 Enrollment ID: I20171120001186 |
| Provider Name | Kylie Jean Altman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013674423 PECOS PAC ID: 7113311580 Enrollment ID: I20220301000531 |
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