# IREDELL PHYSICIAN NETWORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** IREDELL PHYSICIAN NETWORK LLC
- **Other names:** Family Care Center of Mocksville
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1063584134
- **Legal business name:** IREDELL PHYSICIAN NETWORK LLC
- **Authorized official:** MS. VICKIE MORF (REVENUE CYCLE MANAGER)
- **Authorized official phone:** (704) 878-4542

## Contact information

- **Practice address:** 101 WILKESBORO ST STE B, MOCKSVILLE, NC 27028-2321
- **Practice address phone:** (336) 753-0800
- **Practice address fax:** (336) 753-0805
- **Mailing address:** PO BOX 896199, CHARLOTTE, NC 28289-6199
- **Mailing address phone:** (833) 936-1364
- **Mailing address fax:** (605) 942-7505

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 04/27/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5911525 | — | NC |