Organization
IREDELL PHYSICIAN NETWORK, LLC
Active
Parent organization
IREDELL PHYSICIAN NETWORK, LLC
Other names
Iredell Surgery at Mooresville ASC
Organization subpart
Yes
Provider details
NPI number
Legal business name
IREDELL PHYSICIAN NETWORK, LLC
Authorized official
CARLA D JOHNSON (DIRECTOR OF OPERATIONS)
(704) 873-5661
Entity
Organization
Contact information
Practice address
653 BLUEFIELD ROAD, SUITE D, MOORESVILLE, NC 28117
(704) 883-3378
(704) 883-3228
Mailing address
PO BOX 896199, CHARLOTTE, NC 28289-6199
(833) 936-1364
(605) 942-7505
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
05/25/2021
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