| Mp Raines Pc | |
|
2453 Lee Street Rd Americus GA 31709-9260 | |
| (229) 869-9930 | |
| Not Available |
| Full Name | Mp Raines Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 2453 Lee Street Rd, Americus, Georgia |
| Authorized Official Name and Position | Michael P. Raines (OWNER) |
| Authorized Official Contact | 2298699930 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mp Raines Pc Po Box 7282 Americus GA 31709-7282 Ph: (229) 869-9930 | Mp Raines Pc 2453 Lee Street Rd Americus GA 31709-9260 Ph: (229) 869-9930 |
| NPI Number | 1992192900 |
|---|---|
| Provider Enumeration Date | 04/17/2015 |
| Last Update Date | 04/17/2015 |
| Medicare PECOS PAC ID | 2961712633 |
|---|---|
| Medicare Enrollment ID | O20151109001658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992192900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35979 (Georgia) | Primary |
| Provider Name | Michael P Raines |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144215872 PECOS PAC ID: 5991799223 Enrollment ID: I20040412000187 |
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