MEDICARE: LINCOLN JAMES PRIME PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1639972961
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINCOLN JAMES PRIME PLLC

Provider Business Mailing Address
First Line	:	1014 E HIGHWAY 82 # 134
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-2721
Country	:	US
Telephone Number	:	940-284-6649
Fax Number	:	888-292-0671

Provider Business Practice Location Address
First Line	:	201 W CALIFORNIA ST # 16
Second Line	:
City	:	GAINESVILLE
State	:	TX
Zip	:	76240-3904
Country	:	US
Telephone Number	:	940-284-6649
Fax Number	:	888-292-0671

Authorized Official
Title or Position	:	CEO
Name	:	LISA ROY
Credential	:	MD
Telephone Number	:	940-284-6649

Provider Enumeration Date	:	03/31/2025
Last Update Date	:	06/30/2025

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