| Liberty Family Physicians | |
|
1928 Weddington Rd Weddington NC 28104-8318 | |
| (704) 844-0505 | |
| (704) 844-0220 |
| Full Name | Liberty Family Physicians |
|---|---|
| Speciality | Family Medicine |
| Location | 1928 Weddington Rd, Weddington, North Carolina |
| Authorized Official Name and Position | Henry Ronald Emery (CEO) |
| Authorized Official Contact | 7048440505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Family Physicians 1928 Weddington Rd Weddington NC 28104-8318 Ph: (704) 844-0505 | Liberty Family Physicians 1928 Weddington Rd Weddington NC 28104-8318 Ph: (704) 844-0505 |
| NPI Number | 1659775500 |
|---|---|
| Provider Enumeration Date | 10/20/2014 |
| Last Update Date | 12/14/2017 |
| Medicare PECOS PAC ID | 2264756170 |
|---|---|
| Medicare Enrollment ID | O20150126000975 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659775500 | NPI | - | NPPES |
| Q0059W | Medicaid | SC | |
| 89134FA | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 205382 (North Carolina) | Primary |
| Provider Name | Henry R Emery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639149552 PECOS PAC ID: 5193796407 Enrollment ID: I20040802000860 |
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