| NPI | 1578830279 |
|---|---|
| Doing Business As | PROVIDENCE FAMILY MEDICINE LEXINGTON |
| Entity Type | Organization |
| Authorized Contact | ANGELA HAITHCOCK Project Manager 803-865-4780 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2011-11-23 |