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Organization
IREDELL PHYSICIAN NETWORK LLC
Active
Organization
IREDELL PHYSICIAN NETWORK LLC
Active
Parent organization
IREDELL PHYSICIAN NETWORK LLC
Other names
Young Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
IREDELL PHYSICIAN NETWORK LLC
Authorized official
MS. ANNA PURCELL (DIRECTOR)
(704) 878-4569
Entity
Organization
Contact information
Practice address
774 HARTNESS RD, STATESVILLE, NC 28677-3376
(704) 924-7992
(704) 924-7950
Mailing address
PO BOX 25867, WINSTON SALEM, NC 27114-5867
(704) 924-7992
(704) 924-7950
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
96-00787
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5908193
—
NC
Enumeration date
09/24/2007
Last updated
05/12/2010
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