Organization
IREDELL PHYSICIAN NETWORK LLC
Active
Parent organization
IREDELL PHYSICIAN NETWORK LLC
Other names
Iredell Primary Care
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
114 GATEWAY BLVD STE B, MOORESVILLE, NC 28117-5598
(980) 435-0406
(980) 435-0409
Mailing address
PO BOX 896199, CHARLOTTE, NC 28289-6199
(833) 936-1364
(312) 277-5144
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/18/2022
Last updated
03/10/2022
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