| Lake County Primary Care | |
|
710 Carl Perkins Pkwy Tiptonville TN 38079 | |
| (731) 253-6690 | |
| (731) 253-6692 |
| Full Name | Lake County Primary Care |
|---|---|
| Speciality | Clinic/Center |
| Location | 710 Carl Perkins Pkwy, Tiptonville, Tennessee |
| Authorized Official Name and Position | Amber Marie Isbell (FINANCIAL OFFICER) |
| Authorized Official Contact | 7312536690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake County Primary Care 710 Carl Perkins Pkwy Tiptonville TN 38079 Ph: (731) 253-6690 | Lake County Primary Care 710 Carl Perkins Pkwy Tiptonville TN 38079 Ph: (731) 253-6690 |
| NPI Number | 1841311529 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 11/06/2012 |
| Medicare PECOS PAC ID | 6507052073 |
|---|---|
| Medicare Enrollment ID | O20101123000371 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841311529 | NPI | - | NPPES |
| 1992848816 | Other | NPI DR. CAROL GUESS | |
| 444-7958 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Lake County Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Carl Perkins Pkwy, Tiptonville, TN 38079 Phone: 731-253-6690 Fax: 731-253-6692 | |
Main Street Family Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 211 Church St, Tiptonville, TN 38079 Phone: 731-571-0569 |