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Organization
PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C
Active
Organization
PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C
Active
Other names
State Health Plan Primary Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JON LEIZMAN M.D. (PRESIDENT)
(216) 479-9063
Entity
Organization
Contact information
Practice address
121 PARK ST, CANTON, NC 28716-4319
(828) 235-8414
(828) 235-9135
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/24/2006
Last updated
08/24/2022
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