| Lakeland Medical Associates | |
|
117 Medical Circle Athens TX 75751 | |
| (903) 676-3200 | |
| (903) 676-3277 |
| Full Name | Lakeland Medical Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 117 Medical Circle, Athens, Texas |
| Authorized Official Name and Position | Ronald W Heine (CE0) |
| Authorized Official Contact | 9036763200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeland Medical Associates 117 Medical Circle Athens TX 75751 Ph: (903) 676-3200 | Lakeland Medical Associates 117 Medical Circle Athens TX 75751 Ph: (903) 676-3200 |
| NPI Number | 1528063534 |
|---|---|
| Provider Enumeration Date | 06/16/2005 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2567476146 |
|---|---|
| Medicare Enrollment ID | O20060202000852 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528063534 | NPI | - | NPPES |
| 00D969 | Other | TX | BCBS GROUP NUMBER |
| 111549503 | Medicaid | TX | |
| 111549502 | Medicaid | TX |
| Provider Name | Christopher R Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942237078 PECOS PAC ID: 3678476462 Enrollment ID: I20040319000897 |
| Provider Name | Jon M Rich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770520942 PECOS PAC ID: 2668478280 Enrollment ID: I20061004000544 |
| Provider Name | Donald Carney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932104932 PECOS PAC ID: 8426192923 Enrollment ID: I20100222000822 |
| Provider Name | Charles Mettetal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245235266 PECOS PAC ID: 8325182835 Enrollment ID: I20100222000845 |
| Provider Name | Douglas Curran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821093824 PECOS PAC ID: 6305810680 Enrollment ID: I20100222000874 |
| Provider Name | Waleed Mahmoud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366447062 PECOS PAC ID: 7911041421 Enrollment ID: I20100222000901 |
| Provider Name | Steven Koerth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124023130 PECOS PAC ID: 1254475775 Enrollment ID: I20100222000938 |
| Provider Name | Norman L Jennings |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659378925 PECOS PAC ID: 6305841693 Enrollment ID: I20100526000925 |
| Provider Name | Ronald Heine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013912716 PECOS PAC ID: 7315076528 Enrollment ID: I20100526000972 |
| Provider Name | Richard T David |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104821800 PECOS PAC ID: 0143352443 Enrollment ID: I20100722000429 |
| Provider Name | Marcus G Abadie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104821107 PECOS PAC ID: 3678605409 Enrollment ID: I20100825000908 |
| Provider Name | Kristi Shawn Gore Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669758389 PECOS PAC ID: 9032385257 Enrollment ID: I20120110000147 |
| Provider Name | Bruce Woodall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588667182 PECOS PAC ID: 8820051352 Enrollment ID: I20120813000704 |
| Provider Name | Michael Swartwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487883153 PECOS PAC ID: 3173769197 Enrollment ID: I20130418000162 |
| Provider Name | Alicia Cleaver |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730409939 PECOS PAC ID: 3870718240 Enrollment ID: I20140627001893 |
| Provider Name | Haley N Burk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770988149 PECOS PAC ID: 5294058079 Enrollment ID: I20141231001097 |
| Provider Name | Joshua N Splinter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306109228 PECOS PAC ID: 1355661158 Enrollment ID: I20150519001099 |
| Provider Name | Angela M Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457800294 PECOS PAC ID: 0648550442 Enrollment ID: I20161214000717 |
| Provider Name | Jessica Thomason Boldwill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437507514 PECOS PAC ID: 4385935709 Enrollment ID: I20180213002290 |
| Provider Name | Christian J Zuniga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053722355 PECOS PAC ID: 9335404862 Enrollment ID: I20180604000089 |
| Provider Name | Alice R Splinter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033506019 PECOS PAC ID: 9931456555 Enrollment ID: I20180727000215 |
| Provider Name | Renessa L Gerhardt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790216224 PECOS PAC ID: 8426467010 Enrollment ID: I20210512000512 |
| Provider Name | Jonathan P Angel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013448117 PECOS PAC ID: 7618386103 Enrollment ID: I20210513001637 |
| Provider Name | Melissa L Sheldon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689223141 PECOS PAC ID: 6901282235 Enrollment ID: I20221010002414 |
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