| Revolution Family Medicine, Pllc | |
|
56 N Broad St E Angier NC 27501-8964 | |
| (209) 265-8805 | |
| Not Available |
| Full Name | Revolution Family Medicine, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 56 N Broad St E, Angier, North Carolina |
| Authorized Official Name and Position | Jessica M Sloan (OWNER/PHYSICIAN) |
| Authorized Official Contact | 2092658805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revolution Family Medicine, Pllc Po Box 2778 Lillington NC 27546-2778 Ph: () - | Revolution Family Medicine, Pllc 56 N Broad St E Angier NC 27501-8964 Ph: (209) 265-8805 |
| NPI Number | 1740875095 |
|---|---|
| Provider Enumeration Date | 03/08/2021 |
| Last Update Date | 03/22/2021 |
| Medicare PECOS PAC ID | 3476962291 |
|---|---|
| Medicare Enrollment ID | O20210507001171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740875095 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Jessica Marie Sloan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831363399 PECOS PAC ID: 4981876547 Enrollment ID: I20111004000778 |
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