Organization
MOORESVILLE PPM LLC
Active
Parent organization
MOORESVILLE PPM LLC
Other names
First In Flight Neurology
Organization subpart
Yes
Provider details
NPI number
Legal business name
MOORESVILLE PPM LLC
Authorized official
JENNIFER L JACKSON (SR DIR PROV ENROLLMENT & ONBOARDING)
(615) 465-7633
Entity
Organization
Contact information
Practice address
131 MEDICAL PARK RD STE 308, MOORESVILLE, NC 28117-8525
(704) 660-2640
(704) 660-2646
Mailing address
4000 MERIDIAN BLVD, FRANKLIN, TN 37067-6325
(615) 465-7230
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
10/14/2014
Last updated
01/14/2022
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