| Fairmount Family Medicine Pllc | |
|
5006 West Genesee Street Camillus NY 13031-2326 | |
| (315) 234-2342 | |
| (315) 234-0697 |
| Full Name | Fairmount Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 5006 West Genesee Street, Camillus, New York |
| Authorized Official Name and Position | Leland J Jackson (OWNER) |
| Authorized Official Contact | 3152342342 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairmount Family Medicine Pllc 5006 West Genesee Street Camillus NY 13031-2326 Ph: (315) 234-2342 | Fairmount Family Medicine Pllc 5006 West Genesee Street Camillus NY 13031-2326 Ph: (315) 234-2342 |
| NPI Number | 1659491421 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 11/29/2023 |
| Medicare PECOS PAC ID | 0941262240 |
|---|---|
| Medicare Enrollment ID | O20041029000232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659491421 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Leland J Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386616472 PECOS PAC ID: 8022070333 Enrollment ID: I20111221000665 |
Associated Gastroenterologists Of Central New York, Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 260 Township Blvd, Ste 20, Camillus, NY 13031 Phone: 315-708-0190 Fax: 315-488-3284 | |
Preventive Medicine Associates Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5415 W Genesee St, Suite 301, Camillus, NY 13031 Phone: 315-487-8109 Fax: 315-487-5680 |