Provider Demographics
NPI:1629003967
Name:LINCOLNTON MEDICAL GROUP,PLLC
Entity Type:Organization
Organization Name:LINCOLNTON MEDICAL GROUP,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOANLD
Authorized Official - Middle Name:F
Authorized Official - Last Name:BIAS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:704-735-7474
Mailing Address - Street 1:1470 E GASTON ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-4431
Mailing Address - Country:US
Mailing Address - Phone:704-735-7474
Mailing Address - Fax:704-735-8788
Practice Address - Street 1:1470 E GASTON ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-4431
Practice Address - Country:US
Practice Address - Phone:704-735-7474
Practice Address - Fax:704-735-8788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700469207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890176LMedicaid
NC116472OtherWELLPATH
NCCH4510OtherRAILROAD MEDICARE
NC1627444OtherCIGNA
NC0176LOtherBCBS
NC2344586Medicare ID - Type Unspecified
D98014Medicare UPIN
NC2344586Medicare PIN