| Southern Family Medical Center Pc | |
|
3736 Mike Padgett Hwy Ste A Augusta GA 30906-0720 | |
| (706) 560-2273 | |
| (706) 560-0903 |
| Full Name | Southern Family Medical Center Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3736 Mike Padgett Hwy Ste A, Augusta, Georgia |
| Authorized Official Name and Position | Mike Hodnick (PRACTICE MANAGER) |
| Authorized Official Contact | 7065602273 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Family Medical Center Pc 3736 Mike Padgett Hwy Ste A Augusta GA 30906-0720 Ph: (706) 560-2273 | Southern Family Medical Center Pc 3736 Mike Padgett Hwy Ste A Augusta GA 30906-0720 Ph: (706) 560-2273 |
| NPI Number | 1083785349 |
|---|---|
| Provider Enumeration Date | 11/10/2006 |
| Last Update Date | 12/07/2012 |
| Medicare PECOS PAC ID | 5395715056 |
|---|---|
| Medicare Enrollment ID | O20040729000635 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083785349 | NPI | - | NPPES |
| GRPGPA904 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Sean T Lynch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134142474 PECOS PAC ID: 0749250413 Enrollment ID: I20040730000886 |
| Provider Name | James Patrick Walton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578724779 PECOS PAC ID: 8022337187 Enrollment ID: I20150512001677 |
| Provider Name | Lauren Cherie Daniels |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861874380 PECOS PAC ID: 0749540250 Enrollment ID: I20180711001262 |
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