| Primary Care Center Of Lynn Haven | |
|
825 Florida Ave Lynn Haven FL 32444-2335 | |
| (850) 265-3686 | |
| (850) 271-5665 |
| Full Name | Primary Care Center Of Lynn Haven |
|---|---|
| Speciality | Internal Medicine |
| Location | 825 Florida Ave, Lynn Haven, Florida |
| Authorized Official Name and Position | Asim J Khattak (OWNER) |
| Authorized Official Contact | 8502653686 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Center Of Lynn Haven Po Box 1199 Lynn Haven FL 32444-1199 Ph: (850) 265-3686 | Primary Care Center Of Lynn Haven 825 Florida Ave Lynn Haven FL 32444-2335 Ph: (850) 265-3686 |
| NPI Number | 1700803624 |
|---|---|
| Provider Enumeration Date | 07/16/2006 |
| Last Update Date | 10/26/2011 |
| Medicare PECOS PAC ID | 1456456227 |
|---|---|
| Medicare Enrollment ID | O20070424000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700803624 | NPI | - | NPPES |
| 1700803624 | Other | FL | NPI |
| 276096700 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sohail M Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871691386 PECOS PAC ID: 3870528565 Enrollment ID: I20051019000669 |
| Provider Name | Asim J Khattak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578520730 PECOS PAC ID: 2264537034 Enrollment ID: I20070424000227 |
| Provider Name | Lynda J Drinkard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417276007 PECOS PAC ID: 7416143474 Enrollment ID: I20101202000432 |
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