# MAGNOLIA MEDICINE DPC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770459299
- **Authorized official:** JOHANNA HADLEY SAMPSON MD (PHYSICIAN OWNER)
- **Authorized official phone:** (317) 697-8490

## Contact information

- **Practice address:** 600 WADE AVE STE A, RALEIGH, NC 27605-3121
- **Practice address phone:** (919) 228-8155
- **Practice address fax:** (984) 220-9276
- **Mailing address:** 600 WADE AVE STE A, RALEIGH, NC 27605-3121
- **Mailing address phone:** (919) 228-8155
- **Mailing address fax:** (984) 220-9276

## Taxonomy

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

## Other

- **Enumeration date:** 10/13/2025
- **Last updated:** 10/13/2025