| Lifetime Family Medicine Llc | |
|
7869 Villa Rica Hwy Dallas GA 30157-8638 | |
| (770) 459-8449 | |
| Not Available |
| Full Name | Lifetime Family Medicine Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 7869 Villa Rica Hwy, Dallas, Georgia |
| Authorized Official Name and Position | Lisa H Miles (PRACTICE MANAGER) |
| Authorized Official Contact | 7704598449 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifetime Family Medicine Llc 7869 Villa Rica Hwy Dallas GA 30157-8638 Ph: (770) 459-8449 | Lifetime Family Medicine Llc 7869 Villa Rica Hwy Dallas GA 30157-8638 Ph: (770) 459-8449 |
| NPI Number | 1053509216 |
|---|---|
| Provider Enumeration Date | 10/11/2007 |
| Last Update Date | 03/10/2023 |
| Medicare PECOS PAC ID | 3577646736 |
|---|---|
| Medicare Enrollment ID | O20080211000608 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053509216 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QS1200X | Clinic/center - Sleep Disorder Diagnostic | 052082 (Georgia) | Secondary |
| Provider Name | Michael L Miles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760458319 PECOS PAC ID: 5698752970 Enrollment ID: I20040706000184 |
| Provider Name | Erin R Costanzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649244997 PECOS PAC ID: 0547294522 Enrollment ID: I20050920000294 |
| Provider Name | Tara Lynn Favis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013279132 PECOS PAC ID: 7719135557 Enrollment ID: I20120919000608 |
| Provider Name | Shelley Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881149102 PECOS PAC ID: 9830484831 Enrollment ID: I20160829002659 |
| Provider Name | Jessica Alyse Palombo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518524230 PECOS PAC ID: 4486982303 Enrollment ID: I20190829003003 |
| Provider Name | Jarrett Hayles-patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902542152 PECOS PAC ID: 3173905064 Enrollment ID: I20220809003823 |
Wellstar Paulding Nursing Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 600 W Memorial Dr, Dallas, GA 30132 Phone: 770-443-4767 Fax: 770-443-4793 | |
Gregory L. Wehunt, D.o. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 290 Merchants Sq Ste C, Dallas, GA 30132 Phone: 770-443-3335 Fax: 770-443-3394 | |
Cobbwest Internal Medicine Associates Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2713 Charles Hardy Pkwy, Ste 223, Dallas, GA 30157 Phone: 678-324-7021 | |
Centerwell Senior Primary Care Ga Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3615 Charles Hardy Pkwy, Dallas, GA 30157 Phone: 407-447-7120 | |
Primary Care Plus, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 51 Seven Hills Blvd, Suite 102, Dallas, GA 30132 Phone: 678-574-3000 | |
Family Vision Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1498 Merchants Dr, Dallas, GA 30132 Phone: 770-445-2715 |