Healthcare Provider Details

I. General information

NPI: 1063523421
Provider Name (Legal Business Name): LINCOLN FAMILY PRACTICE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/07/2022
Certification Date: 09/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 PATTON CHAPEL RD
LINCOLN AL
35096-4723
US

IV. Provider business mailing address

1100 PATTON CHAPEL RD
LINCOLN AL
35096-4723
US

V. Phone/Fax

Practice location:
  • Phone: 205-763-1414
  • Fax: 205-763-1447
Mailing address:
  • Phone: 205-763-1414
  • Fax: 205-763-1447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: APRIL L PONDER
Title or Position: PRESIDENT
Credential: M.D.
Phone: 205-763-1414