| Main Street Family Care Pllc | |
|
211 Church St Tiptonville TN 38079-1109 | |
| (731) 571-0569 | |
| Not Available |
| Full Name | Main Street Family Care Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 211 Church St, Tiptonville, Tennessee |
| Authorized Official Name and Position | Misty C Barker (NP/OWNER) |
| Authorized Official Contact | 7315710569 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Main Street Family Care Pllc 211 Church St Tiptonville TN 38079-1109 Ph: (731) 571-0569 | Main Street Family Care Pllc 211 Church St Tiptonville TN 38079-1109 Ph: (731) 571-0569 |
| NPI Number | 1770012676 |
|---|---|
| Provider Enumeration Date | 06/06/2017 |
| Last Update Date | 10/31/2019 |
| Medicare PECOS PAC ID | 7113298944 |
|---|---|
| Medicare Enrollment ID | O20180118001553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770012676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Misty C Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407999683 PECOS PAC ID: 6103107966 Enrollment ID: I20170110001703 |
Lake County Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 710 Carl Perkins Pkwy, Tiptonville, TN 38079 Phone: 731-253-6690 Fax: 731-253-6692 | |
Lake County Primary Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 710 Carl Perkins Pkwy, Tiptonville, TN 38079 Phone: 731-253-6690 Fax: 731-253-6692 |