| Lake County Primary Care | |
|
710 Carl Perkins Pkwy Tiptonville TN 38079-1678 | |
| (731) 253-6690 | |
| (731) 253-6692 |
| Full Name | Lake County Primary Care |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 710 Carl Perkins Pkwy, Tiptonville, Tennessee |
| Authorized Official Name and Position | Carol Winfred Guess (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7312536690 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake County Primary Care 710 Carl Perkins Pkwy Tiptonville TN 38079-1678 Ph: (731) 253-6690 | Lake County Primary Care 710 Carl Perkins Pkwy Tiptonville TN 38079-1678 Ph: (731) 253-6690 |
| NPI Number | 1275873424 |
|---|---|
| Provider Enumeration Date | 02/26/2013 |
| Last Update Date | 02/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275873424 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 17394 (Tennessee) | Primary |
Main Street Family Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 Church St, Tiptonville, TN 38079 Phone: 731-571-0569 | |
Lake County Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 710 Carl Perkins Pkwy, Tiptonville, TN 38079 Phone: 731-253-6690 Fax: 731-253-6692 |