Organization
CAROMONT- SOUTH POINT LLC
Active
Other names
South Point Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS LUCKETT (PRESIDENT, CEO)
(704) 834-2133
Entity
Organization
Contact information
Practice address
1220 SPRUCE ST, BELMONT, NC 28012-3370
(704) 825-5333
(704) 825-1751
Mailing address
1220 SPRUCE ST, BELMONT, NC 28012-3370
(704) 825-5333
(704) 825-1751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905651
—
NC
Enumeration date
11/19/2007
Last updated
06/10/2015
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