# IREDELL PHYSICIAN NETWORK, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Iredell Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518215573
- **Authorized official:** JOANIE COCHRAN (CREDENTIALING)
- **Authorized official phone:** (336) 306-9755

## Contact information

- **Practice address:** 544 BRAWLEY SCHOOL RD STE A, MOORESVILLE, NC 28117-9393
- **Practice address phone:** (704) 360-5190
- **Practice address fax:** (704) 360-5180
- **Mailing address:** PO BOX 896199, CHARLOTTE, NC 28289-6199
- **Mailing address phone:** (833) 936-1364
- **Mailing address fax:** (605) 942-7505

## Taxonomy

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

## Other

- **Enumeration date:** 08/23/2012
- **Last updated:** 02/12/2024