Organization
CAROMONT- SOUTH POINT LLC
Active
Other names
South Point Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID M OCONNOR (CFO)
(704) 834-2133
Entity
Organization
Contact information
Practice address
159 E DALLAS RD, STANLEY, NC 28164-2052
(704) 263-0300
(704) 263-1873
Mailing address
159 E DALLAS RD, STANLEY, NC 28164-2052
(704) 263-0300
(704) 263-1873
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905652
—
NC
Enumeration date
10/31/2007
Last updated
04/25/2019
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