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General NPI Number Information
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NPI Number | 1073709333
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Entity Type | Organization
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Legal Business Name | PATIENTS PRIMARY CARE LLC
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Dates
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Enumeration Date | 09/20/2007
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Last Update Date | 09/10/2008
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Provider Practice Location Address
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Address Line | 4413 NW BLITCHTON RD
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City | OCALA
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State | FL
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Zip | 34482-4056
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Country | US
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Telephone | 352-629-8088
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Fax | 352-629-1962
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Provider Business Mailing Address
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Address Line | PO BOX 771706
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City | OCALA
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State | FL
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Zip | 34477-1706
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Country | US
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Telephone | 352-629-8088
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Fax | 352-629-1962
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. LORIJEAN FACKLER
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Credential | ARNP
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Telephone | 352-629-8088
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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