A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Adolescent Medicine |
2080A0000X | 37 | Physician/Pediatric Medicine | |
Anesthesiology |
207L00000X | 79 | Physician/Addiction Medicine | |
Dermatology |
207N00000X | 07 | Physician/Dermatology | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice | |
Infectious Disease |
207RI0200X | 11 | Physician/Internal Medicine | |
Internal Medicine |
207R00000X | 11 | Physician/Internal Medicine | |
Interventional Pain Medicine |
208VP0014X | 09 | Physician/Interventional Pain Management | |
MOHS-Micrographic Surgery |
207ND0101X | 07 | Physician/Dermatology | |
Neurology |
2084N0400X | 13 | Physician/Neurology | |
Obstetrics & Gynecology |
207V00000X | 16 | Physician/Obstetrics & Gynecology | |
Orthopaedic Surgery |
207X00000X | 02 | Physician/General Surgery | |
Pediatrics |
208000000X | 37 | Physician/Pediatric Medicine | |
Plastic Surgery |
208200000X | 02 | Physician/General Surgery | |
Rehabilitation: Cardiac Facilities |
261QR0404X |
| NPI # | 1275522864 |
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| LBN Legal business name | PREMIER FAMILY CARE I, INC | ||||||||||||
| Authorized official | CANDACE WYNNE - (CREDENTIALING) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 10/17/2005 | ||||||||||||
| Last updated | 06/13/2025 - About 12 months ago | ||||||||||||
| Identifiers |
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