# NOVANT HEALTH MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Novant Health Spine Specialists
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568808855
- **Authorized official:** LEEA JEANINE WALTON (RCS MANAGER)
- **Authorized official phone:** (704) 316-6081

## Contact information

- **Practice address:** 190 KIMEL PARK DR STE 140, WINSTON SALEM, NC 27103-6946
- **Practice address phone:** (336) 277-2225
- **Practice address fax:** (336) 277-2231
- **Mailing address:** PO BOX 60447, CHARLOTTE, NC 28260-0447
- **Mailing address phone:** (336) 277-2225
- **Mailing address fax:** (336) 277-2231

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/14/2013
- **Last updated:** 06/24/2024