|
| |
|
12208 N Nc Highway 150 Winston Salem NC 27127-9730 | |
| (336) 764-2324 | |
| (336) 764-9541 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 12208 N Nc Highway 150, Winston Salem, 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 751803 Charlotte NC 28275-1803 Ph: (336) 764-2324 | 12208 N Nc Highway 150 Winston Salem NC 27127-9730 Ph: (336) 764-2324 |
| NPI Number | 1427006451 |
|---|---|
| Provider Enumeration Date | 05/04/2006 |
| Last Update Date | 07/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427006451 | NPI | - | NPPES |
| 01126 | Other | NC | BLUECROSS BLUESHIELD |
| 2688 | Other | NC | BLUE MEDICARE |
| CA1315 | Other | NC | RAILROAD MEDICARE |
| 6901126 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mccorkle Laboratory Enterprise Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 W 5th St Ste 800, Winston Salem, NC 27101 Phone: 336-800-5227 | |
North Carolina General Management Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3051 Waughtown St, Winston Salem, NC 27107 Phone: 336-726-5090 | |
Wake Forest University Health Sciences Primary Care Clinic Medicare: Medicare Enrolled Practice Location: Medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2255 | |
Physicians Eldercare Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4692 Brownsboro Rd, Winston Salem, NC 27106 Phone: 337-991-9276 Fax: 337-943-0846 | |
Preventative Wellness Solutions I Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3878 Oxford Station Way, Winston Salem, NC 27103 Phone: 336-517-0072 | |