# IREDELL PHYSICIAN NETWORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** IREDELL PHYSICIAN NETWORK LLC
- **Other names:** Young Family Practice
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1487840427
- **Legal business name:** IREDELL PHYSICIAN NETWORK LLC
- **Authorized official:** MS. ANNA PURCELL (DIRECTOR)
- **Authorized official phone:** (704) 878-4569

## Contact information

- **Practice address:** 774 HARTNESS RD, STATESVILLE, NC 28677-3376
- **Practice address phone:** (704) 924-7992
- **Practice address fax:** (704) 924-7950
- **Mailing address:** PO BOX 25867, WINSTON SALEM, NC 27114-5867
- **Mailing address phone:** (704) 924-7992
- **Mailing address fax:** (704) 924-7950

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 96-00787 | NC | Yes |

## Other

- **Enumeration date:** 09/24/2007
- **Last updated:** 05/12/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5908193 | — | NC |