Organization
MOORESVILLE PPM, LLC
Active
Organization
MOORESVILLE PPM, LLC
Active
Parent organization
MOORESVILLE PPM, LLC
Other names
Harbor Internal Mediciine
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOORESVILLE PPM, LLC
Authorized official
MRS. JENNY L JACKSON (SR DIR PROV ENROLLMMENT & ONBOARDIN)
(615) 465-3334
Entity
Organization
Contact information
Practice address
478 WILLIAMSON RD, SUITE B, MOORESVILLE, NC 28117-8192
(704) 660-0321
(704) 660-0765
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-3334
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/24/2011
Last updated
01/14/2022
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