Provider Demographics
NPI:1790139475
Name:FAMILY FIRST HEALTH CARE-YALE, PLLC
Entity Type:Organization
Organization Name:FAMILY FIRST HEALTH CARE-YALE, PLLC
Other - Org Name:FAMILY FIRST HEALTH CARE - LEXINGTON
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPHILIMY
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:810-387-9355
Mailing Address - Street 1:5730 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48450-8800
Mailing Address - Country:US
Mailing Address - Phone:810-696-2088
Mailing Address - Fax:810-696-2094
Practice Address - Street 1:5730 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MI
Practice Address - Zip Code:48450-8800
Practice Address - Country:US
Practice Address - Phone:810-696-2088
Practice Address - Fax:810-696-2094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P14810OtherMEDICARE PTAN
MI0G60086OtherBCBS