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10305 Hamptons Park Dr Ste 101 Huntersville NC 28078-7221 | |
| (704) 316-5388 | |
| (704) 316-1848 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 10305 Hamptons Park Dr Ste 101, Huntersville, North Carolina |
| Authorized Official Name and Position | Leea Jeanine Walton (RCS MANAGER) |
| Authorized Official Contact | 7043166081 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 316-5388 | 10305 Hamptons Park Dr Ste 101 Huntersville NC 28078-7221 Ph: (704) 316-5388 |
| NPI Number | 1285882688 |
|---|---|
| Provider Enumeration Date | 08/28/2008 |
| Last Update Date | 06/12/2024 |
| Certification Date | 06/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285882688 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (North Carolina) | Primary |
| 2084S0012X | Psychiatry & Neurology - Sleep Medicine | (North Carolina) | Secondary |
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