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611 N Washington St Suite A Lincolnton GA 30817-6037 | |
(706) 359-4215 | |
(706) 359-1662 |
Full Name | |
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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 |
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Po Box 568 120 Gordon Street Washington GA 30673-0568 Ph: (706) 678-5982 | 611 N Washington St Suite A Lincolnton GA 30817-6037 Ph: (706) 359-4215 |
NPI Number | 1801128863 |
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Provider Enumeration Date | 02/02/2010 |
Last Update Date | 07/24/2016 |
Medicare PECOS PAC ID | 8628051489 |
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Medicare Enrollment ID | O20040611000522 |
Identifier | Type | State | Issuer |
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1801128863 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Provider Name | Michelle Endira Mason Woodard |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1104818806 PECOS PAC ID: 5092849778 Enrollment ID: I20100817000695 |
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 | |
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 |