| Walnut Bottom Family Practice, Llc | |
|
850 Walnut Bottom Rd Suite 305 Carlisle PA 17013-3632 | |
| (717) 960-0052 | |
| (717) 960-0055 |
| Full Name | Walnut Bottom Family Practice, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 850 Walnut Bottom Rd, Carlisle, Pennsylvania |
| Authorized Official Name and Position | Lisa C Myers (OWNER) |
| Authorized Official Contact | 7179600052 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Walnut Bottom Family Practice, Llc 850 Walnut Bottom Rd Suite 305 Carlisle PA 17013-3632 Ph: (717) 960-0052 | Walnut Bottom Family Practice, Llc 850 Walnut Bottom Rd Suite 305 Carlisle PA 17013-3632 Ph: (717) 960-0052 |
| NPI Number | 1437455458 |
|---|---|
| Provider Enumeration Date | 02/09/2011 |
| Last Update Date | 03/08/2011 |
| Medicare PECOS PAC ID | 0840468518 |
|---|---|
| Medicare Enrollment ID | O20110725000056 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437455458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Lisa C Myers |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598742025 PECOS PAC ID: 8527115617 Enrollment ID: I20090407000093 |
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