| Pleasant Garden Family Practice | |
|
1500 Neelley Rd Pleasant Garden NC 27313-9230 | |
| (336) 674-6191 | |
| (336) 674-6496 |
| Full Name | Pleasant Garden Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 1500 Neelley Rd, Pleasant Garden, North Carolina |
| Authorized Official Name and Position | Wilson Oliver Elkins (OWNER) |
| Authorized Official Contact | 3366746191 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pleasant Garden Family Practice Po Box 580 Pleasant Garden NC 27313-0580 Ph: (336) 674-6191 | Pleasant Garden Family Practice 1500 Neelley Rd Pleasant Garden NC 27313-9230 Ph: (336) 674-6191 |
| NPI Number | 1083754709 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 02/20/2024 |
| Medicare PECOS PAC ID | 8921072380 |
|---|---|
| Medicare Enrollment ID | O20040823000050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083754709 | NPI | - | NPPES |
| 8902451 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Wilson O Elkins |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1821174095 PECOS PAC ID: 5092789453 Enrollment ID: I20040830000842 |
| Provider Name | Andrea G Blevins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174601017 PECOS PAC ID: 3072610849 Enrollment ID: I20070514000423 |