| Organization Name: | LINCOLN PRIMARY CARE CENTER |
| NPI Number: | 1265565451 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | REBECCA DAWN SMITH (CREDENTIALING) |
| Mailing Address: | 7400 Lynn Ave Hamlin |
| State: | WV US |
| Postal Code: | 255231138 |
| Phone Number: | 3048245806 |
| Fax Number: | 3048245804 |
| NPI Enumeration Date: | 03/14/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2471M2300X |
| License Number: | 2578 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Radiologic Technologist |
| Taxonomy Specialization: | Mammography |
| Taxonomy Definition: | |