Provider Demographics
NPI:1427023183
Name:LILLINGTON FAMILY MEDICAL CENTER, PA
Entity Type:Organization
Organization Name:LILLINGTON FAMILY MEDICAL CENTER, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:910-893-2641
Mailing Address - Street 1:PO BOX 1687
Mailing Address - Street 2:7 EAST DUNCAN
Mailing Address - City:LILLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27546-1687
Mailing Address - Country:US
Mailing Address - Phone:910-893-2641
Mailing Address - Fax:910-893-3208
Practice Address - Street 1:7 EAST DUNCAN ST
Practice Address - Street 2:
Practice Address - City:LILLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27546-1687
Practice Address - Country:US
Practice Address - Phone:910-893-2641
Practice Address - Fax:910-893-3208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC39715207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC=========OtherTAX IDENTIFICATION