| Lunceford Primary Care, PLLC | |
|
4777 Andrew Jackson Pkwy Ste 101 Hermitage TN 37076-1356 | |
| (615) 889-7010 | |
| (615) 889-0135 |
| Full Name | Lunceford Primary Care, PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 4777 Andrew Jackson Pkwy Ste 101, Hermitage, Tennessee |
| Authorized Official Name and Position | Mary Kathryn Lunceford-levesque (OWNER) |
| Authorized Official Contact | 6158781533 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lunceford Primary Care, PLLC 4777 Andrew Jackson Pkwy Ste 101 Hermitage TN 37076-1356 Ph: (615) 889-7010 | Lunceford Primary Care, PLLC 4777 Andrew Jackson Pkwy Ste 101 Hermitage TN 37076-1356 Ph: (615) 889-7010 |
| NPI Number | 1902619661 |
|---|---|
| Provider Enumeration Date | 01/28/2025 |
| Last Update Date | 01/28/2025 |
| Certification Date | 01/28/2025 |
| Medicare PECOS PAC ID | 9436670056 |
|---|---|
| Medicare Enrollment ID | O20250311002284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902619661 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | () | Primary |
| Provider Name | Mary K Lunceford-levesque |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598372047 PECOS PAC ID: 2365856713 Enrollment ID: I20210127001114 |
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