| Twin Lakes Family Practice Pc | |
|
529 Medical Dr Suite A Livingston TN 38570-1826 | |
| (931) 403-1710 | |
| (931) 403-1711 |
| Full Name | Twin Lakes Family Practice Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 529 Medical Dr, Livingston, Tennessee |
| Authorized Official Name and Position | Matthew Joseph Gaspar (MD PRESIDENT) |
| Authorized Official Contact | 9314031710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Twin Lakes Family Practice Pc Po Box 211 Livingston TN 38570-0211 Ph: (931) 403-1710 | Twin Lakes Family Practice Pc 529 Medical Dr Suite A Livingston TN 38570-1826 Ph: (931) 403-1710 |
| NPI Number | 1255386249 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4981618360 |
|---|---|
| Medicare Enrollment ID | O20060206000848 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255386249 | NPI | - | NPPES |
| 3736212 | Medicaid | TN | |
| 3817249 | Medicaid | TN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 29886 (Tennessee) | Primary |
| Provider Name | Matthew J Gaspar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023095858 PECOS PAC ID: 3870494198 Enrollment ID: I20040119000457 |
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