Organization
CHARLOTTE MEDICAL CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS FORD LAYMON (SENIOR VICE PRESIDENT)
(704) 631-0002
Entity
Organization
Contact information
Practice address
2700 PROVIDENCE RD S, SUITE 320, WAXHAW, NC 28173-6313
(704) 667-6750
(704) 667-6751
Mailing address
PO BOX 601643, CHARLOTTE, NC 28260-1643
(704) 667-6750
(704) 667-6751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NC
207Q00000X
Family Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5919381
—
NC
05
—
NPB549
—
SC
Enumeration date
11/09/2011
Last updated
08/19/2016
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