Full Name | |
---|---|
Speciality | Family Medicine |
Location | 167 Moore Rd, King, North Carolina |
Authorized Official Name and Position | Lewis S Thorp (PRESIDENT CEO) |
Authorized Official Contact | 3367213900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 2468 King NC 27021-2468 Ph: (336) 983-3878 | 167 Moore Rd King NC 27021-8770 Ph: (336) 983-3878 |
NPI Number | 1972596211 |
---|---|
Provider Enumeration Date | 08/23/2005 |
Last Update Date | 04/10/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1972596211 | NPI | - | NPPES |
7690216C | Medicaid | NC | |
2317728P | Other | NC | MEDICARE GROUP NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (North Carolina) | Primary |
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