| Johnston Family Medicine, Pa | |
|
713 Wilkins St Smithfield NC 27577 | |
| (919) 934-1211 | |
| (919) 989-8189 |
| Full Name | Johnston Family Medicine, Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 713 Wilkins St, Smithfield, North Carolina |
| Authorized Official Name and Position | Renee Godwin Watson (PHYSICIAN) |
| Authorized Official Contact | 9199341211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Johnston Family Medicine, Pa 713 Wilkins St Smithfield NC 27577-4647 Ph: (919) 934-1211 | Johnston Family Medicine, Pa 713 Wilkins St Smithfield NC 27577 Ph: (919) 934-1211 |
| NPI Number | 1548331333 |
|---|---|
| Provider Enumeration Date | 11/13/2006 |
| Last Update Date | 12/21/2009 |
| Medicare PECOS PAC ID | 2466592985 |
|---|---|
| Medicare Enrollment ID | O20091214000796 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548331333 | NPI | - | NPPES |
| 8902003 | Medicaid | NC | |
| 02003 | Other | BCBS GRP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9601754 (* (Not Available)) | Primary |
| Provider Name | Renee G Watson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669420089 PECOS PAC ID: 1557401072 Enrollment ID: I20091214000795 |
| Provider Name | Debra S Orr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861922379 PECOS PAC ID: 4183995566 Enrollment ID: I20170802003868 |
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