Organization
STATESVILLE HMA MEDICAL GROUP, LLC
Active
Parent organization
STATESVILLE HMA MEDICAL GROUP LLC
Other names
Statesville Cardiology
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
349 BROOKDALE DR, STATESVILLE, NC 28677-4103
(704) 878-2058
(704) 872-6576
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7230
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
10/24/2011
Last updated
01/14/2022
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