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502 W King St Suite A Kings Mountain NC 28086-3362 | |
(980) 487-2290 | |
(704) 730-8472 |
Full Name | |
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Speciality | Internal Medicine |
Location | 502 W King St, Kings Mountain, North Carolina |
Authorized Official Name and Position | Daniel L. Wiens (SR. VICE PRESIDENT) |
Authorized Official Contact | 7043550648 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 601884 Charlotte NC 28260-1884 Ph: (980) 487-2290 | 502 W King St Suite A Kings Mountain NC 28086-3362 Ph: (980) 487-2290 |
NPI Number | 1447585542 |
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Provider Enumeration Date | 10/07/2009 |
Last Update Date | 01/25/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447585542 | NPI | - | NPPES |
NPB348 | Medicaid | SC | |
5914428 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Southern Clinics And Urgent Care Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 502 W King St, Ll 20, Kings Mountain, NC 28086 Phone: 704-865-2755 Fax: 704-865-5013 | |
Kings Clinic And Urgent Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 407 W. King Street, Suite 20, Kings Mountain, NC 28086 Phone: 704-730-8461 |