| Lexington Family Practice Ballentine | |
|
1846 Dutch Fork Road Irmo SC 29063 | |
| (803) 781-5200 | |
| (803) 781-3843 |
| Full Name | Lexington Family Practice Ballentine |
|---|---|
| Speciality | Family Medicine |
| Location | 1846 Dutch Fork Road, Irmo, South Carolina |
| Authorized Official Name and Position | Melinda Sarvis (EXECUTIVE VP) |
| Authorized Official Contact | 8037912000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lexington Family Practice Ballentine Po Box 896239 Charlotte NC 28289-6239 Ph: (803) 781-5200 | Lexington Family Practice Ballentine 1846 Dutch Fork Road Irmo SC 29063 Ph: (803) 781-5200 |
| NPI Number | 1154354827 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 09/17/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154354827 | NPI | - | NPPES |
| GP4189 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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