# MOORESVILLE PPM LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MOORESVILLE PPM LLC
- **Other names:** Primary Care Associates-Williamson
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1225305576
- **Legal business name:** MOORESVILLE PPM LLC
- **Authorized official:** MRS. JENNY L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
- **Authorized official phone:** (615) 465-3334

## Contact information

- **Practice address:** 396 WILLIAMSON RD, MOORESVILLE, NC 28117-5935
- **Practice address phone:** (704) 664-2216
- **Practice address fax:** (704) 664-6529
- **Mailing address:** 4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
- **Mailing address phone:** (615) 465-7230

## Taxonomy

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

## Other

- **Enumeration date:** 11/30/2011
- **Last updated:** 01/14/2022