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Organization
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS
Active
Organization
WAKE FOREST UNIVERSITY BAPTIST MEDICAL CENTER COMMUNITY PHYSICIANS
Active
Other names
Young Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEWIS S THORP III (PRESIDENT CEO)
(336) 659-5116
Entity
Organization
Contact information
Practice address
509 BROOKDALE DR, YOUNG FAMILY PRACTICE, STATESVILLE, NC 28677-4107
(704) 924-7992
(704) 924-7950
Mailing address
509 BROOKDALE DR, YOUNG FAMILY PRACTICE, STATESVILLE, NC 28677-4107
(704) 924-7992
(704) 924-7950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89015T3
—
NC
Enumeration date
08/23/2005
Last updated
08/22/2020
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