Organization
QUICK DOC NC, PA
Active
Other names
Old Town Immediate Care, P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
HENRY FRANKLIN TRIPP JR. M.D. (DIRECTOR)
(336) 993-3146
Entity
Organization
Contact information
Practice address
3734 REYNOLDA RD, WINSTON SALEM, NC 27106-2240
(336) 922-1102
(336) 922-5012
Mailing address
3734 REYNOLDA RD, WINSTON SALEM, NC 27106-2240
(336) 922-1102
(336) 922-5012
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
—
—
261QP2300X
Primary Care Clinic/Center
Primary
40655
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01791
BLS
NC
01
—
40655
MEDICAL BOARD
NC
05
—
5922000
—
NC
Enumeration date
03/29/2007
Last updated
10/08/2020
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