| Landmark Medical Of Tennessee Pc | |
|
506 Main St Westbrook ME 04092-4387 | |
| (572) 372-4506 | |
| Not Available |
| Full Name | Landmark Medical Of Tennessee Pc |
|---|---|
| Speciality | General Practice |
| Location | 506 Main St, Westbrook, Maine |
| Authorized Official Name and Position | Michael Huy Le (CHIEF MEDICAL OFFICER) |
| Authorized Official Contact | 6572372450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Landmark Medical Of Tennessee Pc 7755 Center Ave Ste 630 Huntington Beach CA 92647-9152 Ph: (657) 237-2450 | Landmark Medical Of Tennessee Pc 506 Main St Westbrook ME 04092-4387 Ph: (572) 372-4506 |
| NPI Number | 1982310439 |
|---|---|
| Provider Enumeration Date | 01/27/2023 |
| Last Update Date | 01/27/2023 |
| Medicare PECOS PAC ID | 8527453851 |
|---|---|
| Medicare Enrollment ID | O20230628001076 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982310439 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Stephen Kelly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558504258 PECOS PAC ID: 7113185117 Enrollment ID: I20140918001482 |
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