| Traditional Family Healthcare | |
|
202 Watercress Dr Lizella GA 31052-3636 | |
| (478) 935-9055 | |
| Not Available |
| Full Name | Traditional Family Healthcare |
|---|---|
| Speciality | Family Medicine |
| Location | 202 Watercress Dr, Lizella, Georgia |
| Authorized Official Name and Position | Brian O Reese (OWNER) |
| Authorized Official Contact | 4789359055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Traditional Family Healthcare Po Box 575 Lizella GA 31052-0575 Ph: (478) 935-9055 | Traditional Family Healthcare 202 Watercress Dr Lizella GA 31052-3636 Ph: (478) 935-9055 |
| NPI Number | 1760646095 |
|---|---|
| Provider Enumeration Date | 07/16/2008 |
| Last Update Date | 09/03/2010 |
| Medicare PECOS PAC ID | 7911066378 |
|---|---|
| Medicare Enrollment ID | O20081030000512 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760646095 | NPI | - | NPPES |
| 00083794E | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 044319 (Georgia) | Primary |
| Provider Name | Brian O Reese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629088521 PECOS PAC ID: 6103875562 Enrollment ID: I20050113000039 |
C19 Rapid Testing Solution Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Park View Ct, Lizella, GA 31052 Phone: 786-351-5729 |