| Derrick Lane, MD, LLC | |
|
818 Forsyth St Macon GA 31201-2139 | |
| (478) 633-7010 | |
| (478) 633-7585 |
| Full Name | Derrick Lane, MD, LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 818 Forsyth St, Macon, Georgia |
| Authorized Official Name and Position | Derrick Lane (OWNER) |
| Authorized Official Contact | 4783351365 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Derrick Lane, MD, LLC Po Box 28170 Macon GA 31221-8170 | Derrick Lane, MD, LLC 818 Forsyth St Macon GA 31201-2139 Ph: (478) 633-7010 |
| NPI Number | 1750620191 |
|---|---|
| Provider Enumeration Date | 02/05/2013 |
| Last Update Date | 02/05/2013 |
| Medicare PECOS PAC ID | 0547415309 |
|---|---|
| Medicare Enrollment ID | O20130227000369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750620191 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 052594 (Georgia) | Primary |
| Provider Name | Derrick F Lane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124079447 PECOS PAC ID: 3577502186 Enrollment ID: I20050503000132 |
Harbormed Care of Ga PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3051 Whiteside Rd, Macon, GA 31216 Phone: 478-347-2400 |
Harvey Jones MD PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1385 Pio Nono Ave, Macon, GA 31204 Phone: 478-743-1883 |
First Choice Primary Care, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2460 Shurling Dr, Macon, GA 31211 Phone: 478-787-4266 Fax: 478-787-4199 |
Internal Medicine Associates, P.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 330 Hospital Dr, Bldg C, Ste 200, Macon, GA 31217 Phone: 478-745-1191 Fax: 478-750-4669 |
Metabolic Health of Lawrenceville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2040 Bowman Park Ste D, Macon, GA 31210 Phone: 678-431-1119 |
New Chance Centers LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2733 Sheraton Dr Ste 110, Macon, GA 31204 Phone: 478-202-7273 Fax: 478-239-0094 |