Provider Demographics
NPI:1568524635
Name:LINCOLN FAMILY MEDICINE P.C.
Entity Type:Organization
Organization Name:LINCOLN FAMILY MEDICINE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLCORN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:660-547-3915
Mailing Address - Street 1:302 N. HWY 65
Mailing Address - Street 2:PO BOX 338
Mailing Address - City:LINCOLN
Mailing Address - State:MO
Mailing Address - Zip Code:65338
Mailing Address - Country:US
Mailing Address - Phone:660-547-3915
Mailing Address - Fax:660-547-3019
Practice Address - Street 1:302 NORTH HIGHWAY 65
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MO
Practice Address - Zip Code:65338
Practice Address - Country:US
Practice Address - Phone:660-547-3915
Practice Address - Fax:660-547-3019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB220000Medicare ID - Type UnspecifiedMEDICARE