Organization
STATESVILLE HMA MEDICAL GROUP, LLC
Active
Parent organization
STATESVILLE HMA MEDICAL GROUP LLC
Other names
Statesville Orthopedics & Sports Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATESVILLE HMA MEDICAL GROUP LLC
Authorized official
MRS. JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-3334
Entity
Organization
Contact information
Practice address
340 SIGNAL HILL DR, SUITE A, STATESVILLE, NC 28625-4483
(704) 873-6065
(704) 873-6059
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7230
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
Other
Enumeration date
10/04/2011
Last updated
01/14/2022
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