Patient Centered Physician's Care, P.c. | |
25 Security Dr Jackson TN 38305-3754 | |
(731) 215-2888 | |
(731) 215-2880 |
Full Name | Patient Centered Physician's Care, P.c. |
---|---|
Speciality | Family Medicine |
Location | 25 Security Dr, Jackson, Tennessee |
Authorized Official Name and Position | Kimberly A Howerton (MD) |
Authorized Official Contact | 7312152888 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Patient Centered Physician's Care, P.c. 25 Security Dr Jackson TN 38305-3754 Ph: (731) 215-2888 | Patient Centered Physician's Care, P.c. 25 Security Dr Jackson TN 38305-3754 Ph: (731) 215-2888 |
NPI Number | 1700197183 |
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Provider Enumeration Date | 06/30/2010 |
Last Update Date | 08/12/2010 |
Medicare PECOS PAC ID | 8921124959 |
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Medicare Enrollment ID | O20100928000786 |
Identifier | Type | State | Issuer |
---|---|---|---|
1700197183 | NPI | - | NPPES |
1518542 | Medicaid | TN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 31314 (Tennessee) | Primary |
207V00000X | Obstetrics & Gynecology | 31314 (Tennessee) | Secondary |
Provider Name | Kimberly Ann Howerton |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1922002336 PECOS PAC ID: 5092743039 Enrollment ID: I20050801000128 |
Provider Name | Cara R Roberson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093057465 PECOS PAC ID: 6800038985 Enrollment ID: I20130820000885 |
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