# PREMISE HEALTH OF NORTH CAROLINA MEDICAL, P.C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LifeConnections Clinic At RTP
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770870495
- **Authorized official:** JON LEIZMAN MD (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 7100-9 KIT CREEK RD, RESEARCH TRIANGLE, NC 27709-0001
- **Practice address phone:** (919) 392-0536
- **Practice address fax:** (919) 941-9351
- **Mailing address:** 5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QP2300X | Primary Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 07/01/2011
- **Last updated:** 08/24/2022