Organization
WILKES PHYSICIAN NETWORK, INC.
Active
Parent organization
WILKES PHYSICIAN NETWORK, INC.
Other names
Wilkes Regional Gastroenterology
Organization subpart
Yes
Provider details
NPI number
Legal business name
WILKES PHYSICIAN NETWORK, INC.
Authorized official
FRIEDA M LOWDER (SR. VP)
(704) 403-4146
Entity
Organization
Contact information
Practice address
1404 WILLOW LN, WILKES REGIONAL GASTROENTEROLOGY, NORTH WILKESBORO, NC 28659-3584
(336) 651-3603
(336) 651-3610
Mailing address
1404 WILLOW LN, WILKES REGIONAL GASTROENTEROLOGY, NORTH WILKESBORO, NC 28659-3584
(336) 651-3603
(336) 651-3610
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2335816
MEDICARE PTAN
NC
05
—
5914561
—
NC
Enumeration date
01/19/2010
Last updated
08/23/2010
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