MEDICARE: TRINITY FAMILY MEDICINE, P.A.

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	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851386510
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRINITY FAMILY MEDICINE, P.A.

Provider Business Mailing Address
First Line	:	112 MEDICAL VILLAGE DR
Second Line	:	UNIT D
City	:	WALLACE
State	:	NC
Zip	:	28466-1668
Country	:	US
Telephone Number	:	910-285-7592
Fax Number	:	910-285-4610

Provider Business Practice Location Address
First Line	:	112 MEDICAL VILLAGE DR
Second Line	:	UNIT D
City	:	WALLACE
State	:	NC
Zip	:	28466-1668
Country	:	US
Telephone Number	:	910-285-7592
Fax Number	:	910-285-4610

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GARY STEPHEN CRAWFORD
Credential	:	M.D.
Telephone Number	:	910-285-7592

Provider Enumeration Date	:	09/19/2005
Last Update Date	:	02/24/2009

Similar Medicare Providers

1619963121 — GARY STEPHEN CRAWFORD M.D.
Practice Location Address:

112 MEDICAL VILLAGE DR , UNIT D
WALLACE, NC
28466-1668

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Practice Fax: 910-285-4610

1740331545 — DR. ROXIE C WELLS M.D.
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Practice Location Address:

112 MEDICAL VILLAGE DR , SUITE A
WALLACE, NC
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Practice Phone: 910-285-9002
Practice Fax:

1356642342 — CAROLINA HEALTHCARE ASSOCIATES INC
Practice Location Address:

112 MEDICAL VILLAGE DR , STE G
WALLACE, NC
28466-1668

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Practice Fax:

1144226374 — MARY A FRANKOS M.D.
Practice Location Address:

112 MEDICAL VILLAGE DR , UNIT F
WALLACE, NC
28466-9999

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1528067519 — DR. DANIEL MICHAEL RICCI M.D.
Practice Location Address:

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