| Lewisburg Family Practice | |
|
1090 N Ellington Pkwy Suite 102 Lewisburg TN 37091-2227 | |
| (931) 359-0019 | |
| Not Available |
| Full Name | Lewisburg Family Practice |
|---|---|
| Speciality | Clinic/Center |
| Location | 1090 N Ellington Pkwy, Lewisburg, Tennessee |
| Authorized Official Name and Position | Charles J Brinkley (CFO) |
| Authorized Official Contact | 9315404212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewisburg Family Practice Po Box 100054 Atlanta GA 30348-0054 Ph: () - | Lewisburg Family Practice 1090 N Ellington Pkwy Suite 102 Lewisburg TN 37091-2227 Ph: (931) 359-0019 |
| NPI Number | 1578921763 |
|---|---|
| Provider Enumeration Date | 02/03/2016 |
| Last Update Date | 08/08/2024 |
| Medicare PECOS PAC ID | 4688569718 |
|---|---|
| Medicare Enrollment ID | O20160406000404 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578921763 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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