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Organization
STATESVILLE HMA MEDICAL GROUP, LLC
Active
Organization
STATESVILLE HMA MEDICAL GROUP, LLC
Active
Parent organization
STATESVILLE HMA MEDICAL GROUP LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATESVILLE HMA MEDICAL GROUP LLC
Authorized official
MRS. JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
1412 FERN CREEK DR, STATESVILLE, NC 28625-9376
(704) 660-4145
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7000
(615) 628-6877
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/01/2009
Last updated
01/14/2022
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