Organization
IREDELL PHYSICIAN NETWORK LLC
Active
Parent organization
IREDELL PHYSICIAN NETWORK LLC
Other names
Iredell Ambulatory Surgery Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
IREDELL PHYSICIAN NETWORK LLC
Authorized official
JOANIE M COCHRAN (CREDENTIALING COORDINATOR)
(336) 306-9755
Entity
Organization
Contact information
Practice address
701 BRYANT ST, STATESVILLE, NC 28677-4142
(704) 380-2711
(704) 380-2747
Mailing address
PO BOX 896199, CHARLOTTE, NC 28289-4107
(446) 520-6118
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
10/03/2017
Last updated
05/01/2024
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