Organization
EVERSIDE HEALTH LLC KENTUCKY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT)
(704) 936-5546
Entity
Organization
Contact information
Practice address
100 RONNIE GREENWELL RD, BRANDENBURG, KY 40108-5452
(704) 529-6161
Mailing address
4651 CHARLOTTE PARK DR STE 300, CHARLOTTE, NC 28217-1916
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
—
—
Other
Enumeration date
03/23/2022
Last updated
03/23/2022
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