| Hospital Authority Of Wilkes County | |
|
611 N Washington St Suite A Lincolnton GA 30817-6037 | |
| (706) 359-4215 | |
| (706) 359-1662 |
| Full Name | Hospital Authority Of Wilkes County |
|---|---|
| Speciality | Clinic/Center |
| Location | 611 N Washington St, Lincolnton, Georgia |
| Authorized Official Name and Position | Tracie P Haughey (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7066789212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hospital Authority Of Wilkes County 611 N Washington St Ste A Lincolnton GA 30817-6037 Ph: (706) 359-4215 | Hospital Authority Of Wilkes County 611 N Washington St Suite A Lincolnton GA 30817-6037 Ph: (706) 359-4215 |
| NPI Number | 1801128863 |
|---|---|
| Provider Enumeration Date | 02/02/2010 |
| Last Update Date | 02/14/2025 |
| Medicare PECOS PAC ID | 8628051489 |
|---|---|
| Medicare Enrollment ID | O20040611000522 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801128863 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Lester T Johnston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518975754 PECOS PAC ID: 3870539638 Enrollment ID: I20050701000064 |
| Provider Name | Michelle Endira Mason Woodard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104818806 PECOS PAC ID: 5092849778 Enrollment ID: I20100817000695 |
| Provider Name | Jessica Rene Berry Cofer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962809525 PECOS PAC ID: 4486062866 Enrollment ID: I20210423001489 |
| Provider Name | Nicholas Benjamin Clemmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881357127 PECOS PAC ID: 7810386190 Enrollment ID: I20211108000096 |
| Provider Name | Lee Anthony Dinning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770945628 PECOS PAC ID: 2163719378 Enrollment ID: I20220210000863 |
| Provider Name | Ra'shead Pompey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871158881 PECOS PAC ID: 5496082125 Enrollment ID: I20220810001847 |
| Provider Name | Jacob Evansun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770281784 PECOS PAC ID: 9133577950 Enrollment ID: I20231204002960 |
Lincolnton Health Clinicllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 111 S Washington St, Lincolnton, GA 30817 Phone: 706-359-1115 Fax: 706-359-6365 | |
Family Care Group Of Thomson, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 N Washington St, Lincolnton, GA 30817 Phone: 706-359-6070 Fax: 706-359-7370 | |
Neighborhood Improvement Project Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 123 North Washington Street, Lincolnton, GA 30817 Phone: 706-790-4440 Fax: 706-790-4393 |