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Organization
IREDELL PHYSICIAN NETWORK, LLC
Active
Organization
IREDELL PHYSICIAN NETWORK, LLC
Active
Other names
Iredell Occupational Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA D JOHNSON (DIRECTOR OF OPERATIONS)
(704) 495-3162
Entity
Organization
Contact information
Practice address
653 BLUEFIELD RD, STE B, MOORESVILLE, NC 28117
(980) 444-2630
(980) 444-2631
Mailing address
PO BOX 896199, CHARLOTTE, NC 28289-6199
(833) 936-1364
(605) 942-7505
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
261QX0100X
Occupational Medicine Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/01/2015
Last updated
07/28/2021
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