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Organization

IREDELL PHYSICIAN NETWORK LLC

Active
Other names
Iredell Ear, Nose and Throat
Organization subpart
No

Provider details

NPI number
Authorized official
CARLA D JOHNSON (DIRECTOR OF OPERATIONS)
(980) 434-3803
Entity
Organization

Contact information

Practice address
740 BRYANT ST, STATESVILLE, NC 28677-4143
(704) 878-6272
(704) 878-6273
Mailing address
766 HARTNESS RD STE B, STATESVILLE, NC 28677-3485

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary

Other

Enumeration date
01/29/2025
Last updated
01/29/2025
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