| Lakeville Family Medicine Pc | |
|
5 Precinct St Lakeville MA 02347-1427 | |
| (508) 947-6666 | |
| Not Available |
| Full Name | Lakeville Family Medicine Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5 Precinct St, Lakeville, Massachusetts |
| Authorized Official Name and Position | Robert James Gagnon (PRESIDENT) |
| Authorized Official Contact | 5089476666 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeville Family Medicine Pc 5 Precinct St Lakeville MA 02347-1427 Ph: (508) 947-6666 | Lakeville Family Medicine Pc 5 Precinct St Lakeville MA 02347-1427 Ph: (508) 947-6666 |
| NPI Number | 1356545800 |
|---|---|
| Provider Enumeration Date | 06/11/2007 |
| Last Update Date | 10/12/2010 |
| Medicare PECOS PAC ID | 0840360236 |
|---|---|
| Medicare Enrollment ID | O20080528000042 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356545800 | NPI | - | NPPES |
| M17688 | Other | MA | MASS BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 81226 (Massachusetts) | Primary |
| Provider Name | Robert J Gagnon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124090493 PECOS PAC ID: 4082668934 Enrollment ID: I20050303000781 |
| Provider Name | Jennifer L Koester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407446909 PECOS PAC ID: 9032589023 Enrollment ID: I20230109002029 |
Total Approach Therapy, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 104 Charles Eldridge Drive, Lakeville, MA 02347 Phone: 508-944-9907 Fax: 508-947-0479 |