| Lewisburg Pediatrics | |
|
1090 N Ellington Pkwy Suite 201 Lewisburg TN 37091-2227 | |
| (931) 270-3655 | |
| Not Available |
| Full Name | Lewisburg Pediatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 1090 N Ellington Pkwy, Lewisburg, Tennessee |
| Authorized Official Name and Position | Charles J Brinkley (CFO) |
| Authorized Official Contact | 9315404212 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lewisburg Pediatrics 617 W Main St Hohenwald TN 38462-1355 Ph: () - | Lewisburg Pediatrics 1090 N Ellington Pkwy Suite 201 Lewisburg TN 37091-2227 Ph: (931) 270-3655 |
| NPI Number | 1679937783 |
|---|---|
| Provider Enumeration Date | 04/06/2016 |
| Last Update Date | 08/04/2022 |
| Medicare PECOS PAC ID | 4688569718 |
|---|---|
| Medicare Enrollment ID | O20160526000374 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679937783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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