| First State Family Practice, Inc | |
|
222 Carter Dr Suite 101 Middletown DE 19709-5854 | |
| (302) 378-5494 | |
| (302) 378-1760 |
| Full Name | First State Family Practice, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 222 Carter Dr, Middletown, Delaware |
| Authorized Official Name and Position | John Kehagias (PHYSICIAN/OWNER) |
| Authorized Official Contact | 3023785494 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| First State Family Practice, Inc 222 Carter Dr Suite 101 Middletown DE 19709-5854 Ph: (302) 378-5494 | First State Family Practice, Inc 222 Carter Dr Suite 101 Middletown DE 19709-5854 Ph: (302) 378-5494 |
| NPI Number | 1821172834 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 03/19/2012 |
| Medicare PECOS PAC ID | 3870532435 |
|---|---|
| Medicare Enrollment ID | O20050503000537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821172834 | NPI | - | NPPES |
| 1000021662 | Medicaid | DE | |
| 080195041 | Other | DE | RAILROAD MEDICARE |
| 2148253000 | Other | DE | AMERIHEALTH HMO |
| 1000021662 | Other | DE | DPCI |
| 1463747 | Other | DE | AMERIHEALTH PPO |
| 3157375 | Other | DE | AETNA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C10006722 (Delaware) | Primary |
| Provider Name | Ioannis Kehagias |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497839419 PECOS PAC ID: 5597837187 Enrollment ID: I20080626000050 |
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