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300 N Salisbury Ave Spencer NC 28159-2514 | |
(704) 633-7070 | |
(704) 633-7627 |
Full Name | |
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Speciality | Family Medicine |
Location | 300 N Salisbury Ave, Spencer, North Carolina |
Authorized Official Name and Position | Lloyd Emery Nickerson (OWNER MEDICAL DOCTOR) |
Authorized Official Contact | 7046337070 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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300 N Salisbury Ave Spencer NC 28159-2514 Ph: (704) 633-7070 | 300 N Salisbury Ave Spencer NC 28159-2514 Ph: (704) 633-7070 |
NPI Number | 1528045390 |
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Provider Enumeration Date | 12/22/2005 |
Last Update Date | 06/06/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1528045390 | NPI | - | NPPES |
89014CE | Other | NC | MEDICAID |
0138R | Other | BCBS GROUP ID | |
202595 | Other | BLACK LUNG | |
890138R | Medicaid | NC | |
CL2573 | Other | NC | RAILROAD MEDICARE |
970029646 | Other | MEDICARE RAILROAD | |
8962644 | Medicaid | NC | |
500013139 | Other | MEDICARE RAILROAD | |
62644 | Other | BCBS PERSONAL ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Family Medical Care Of Rowan-spencer Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 117 5th St, Spencer, NC 28159 Phone: 704-639-9124 Fax: 704-639-9717 | |