Statesville Family Practice

LBN: Iredell Physician Network Llc
Statesville Family Practice is an health care organization with primary practice located at 310 Davie Ave , Statesville NC 28677-5319. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Iredell Physician Network Llc can be contacted via phone (704) 873-3269, or through Johnson, Carla via phone (704) 873-5661.

Contact Information

Primary practice address
310 Davie Ave Statesville NC 28677-5319
Phone: (704) 873-3269
Fax: (704) 871-8159
Website:
Map and Directions
Authorized official contact:
Name: Johnson, Carla
Phone: (704) 873-5661

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1053360180
LBN Legal business name Iredell Physician Network Llc
DBA Doing business as Statesville Family Practice
Authorized official Johnson, Carla
Entity Organization
Organization subpart 1 Yes
Enumeration date May 8th, 2006
Last updated Feb 4th, 2022 - about 2 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053360180 NPPES
North Carolina MEDICAID 8902748

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