Provider Demographics
NPI:1942809108
Name:LEXINGTON PRIMARY CARE LLC
Entity Type:Organization
Organization Name:LEXINGTON PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:AFAQ
Authorized Official - Middle Name:ALAM
Authorized Official - Last Name:GUL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-331-9113
Mailing Address - Street 1:777 ATHENS RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30648-1902
Mailing Address - Country:US
Mailing Address - Phone:770-331-9113
Mailing Address - Fax:
Practice Address - Street 1:777 ATHENS RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:GA
Practice Address - Zip Code:30648-1902
Practice Address - Country:US
Practice Address - Phone:770-331-9113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care