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Organization
OLDTOWN IMMEDIATE CARE, PA
Active
Organization
OLDTOWN IMMEDIATE CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY FRANKLIN TRIPP JR. M.D (MEDICAL DIRECTOR)
(336) 993-3146
Entity
Organization
Contact information
Practice address
3690 REYNOLDA RD, WINSTON SALEM, NC 27106-2240
(336) 922-1363
(336) 922-0723
Mailing address
PO BOX 30575, WINSTON SALEM, NC 27130-0575
(336) 922-1363
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
40655
NC
Other
Enumeration date
11/29/2012
Last updated
12/13/2012
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