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Organization

IREDELL PHYSICIAN NETWORK LLC

Active
Parent organization
IREDELL PHYSICIAN NETWORK LLC
Other names
Iredell Imaging at Mooresville
Organization subpart
Yes

Provider details

NPI number
Legal business name
IREDELL PHYSICIAN NETWORK LLC
Authorized official
CARLA D JOHNSON (DIRECTOR OF OPERATIONS)
(704) 873-5661
Entity
Organization

Contact information

Practice address
653 BLUEFIELD RD STE C, MOORESVILLE, NC 28117-9626
(704) 360-6460
(704) 883-3228
Mailing address
PO BOX 896199, CHARLOTTE, NC 28289-6199
(833) 936-1364
(605) 942-7505

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Enumeration date
04/27/2021
Last updated
03/28/2022
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