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407 Mulberry St Sw Lenoir NC 28645-5722 | |
| (828) 757-5100 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 407 Mulberry St Sw, Lenoir, North Carolina |
| Authorized Official Name and Position | Karen Shadowens (CFO) |
| Authorized Official Contact | 3366278512 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
321 Mulberry St Sw Lenoir NC 28645-5720 Ph: (828) 757-5100 | 407 Mulberry St Sw Lenoir NC 28645-5722 Ph: (828) 757-5100 |
| NPI Number | 1538783915 |
|---|---|
| Provider Enumeration Date | 06/02/2020 |
| Last Update Date | 01/21/2025 |
| Certification Date | 01/21/2025 |
| Medicare PECOS PAC ID | 5395646970 |
|---|---|
| Medicare Enrollment ID | O20241013000062 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538783915 | NPI | - | NPPES |
| Provider Name | Weston Geddings |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902168784 PECOS PAC ID: 5698069334 Enrollment ID: I20241013000075 |
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