Organization
EVERSIDE HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL JOHNSON PATTON (DIRECTOR OF RISK MANAGEMENT)
(704) 936-5546
Entity
Organization
Contact information
Practice address
120 N FRANKLIN STREET, SUITE 1, DECATUR, IL 62523
(866) 808-6005
Mailing address
4651 CHARLOTTE PARK DR STE 300, CHARLOTTE, NC 28217-1916
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/21/2021
Last updated
01/21/2022
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