| Highland Family Practice Pa | |
|
1248 Fort Bragg Rd Fayetteville NC 28305-4728 | |
| (910) 323-0334 | |
| (888) 391-5874 |
| Full Name | Highland Family Practice Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 1248 Fort Bragg Rd, Fayetteville, North Carolina |
| Authorized Official Name and Position | George Constantine Pantelakos (MD OWNER) |
| Authorized Official Contact | 9103230334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Highland Family Practice Pa 1248 Fort Bragg Rd Fayetteville NC 28305-4728 Ph: (910) 323-0334 | Highland Family Practice Pa 1248 Fort Bragg Rd Fayetteville NC 28305-4728 Ph: (910) 323-0334 |
| NPI Number | 1891782033 |
|---|---|
| Provider Enumeration Date | 10/03/2005 |
| Last Update Date | 08/08/2012 |
| Medicare PECOS PAC ID | 3476623356 |
|---|---|
| Medicare Enrollment ID | O20080604000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891782033 | NPI | - | NPPES |
| 896518E | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 39456 (North Carolina) | Primary |
| Provider Name | George C Pantelakos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679597025 PECOS PAC ID: 8022188903 Enrollment ID: I20080604000165 |
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