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111 S Salisbury Gq Ave Salisbury NC 28146-8150 | |
(704) 279-1679 | |
(704) 279-1677 |
Full Name | |
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Speciality | Family Medicine |
Location | 111 S Salisbury Gq Ave, Salisbury, 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 |
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Po Box 60447 Charlotte NC 28260-0447 Ph: (704) 279-1679 | 111 S Salisbury Gq Ave Salisbury NC 28146-8150 Ph: (704) 279-1679 |
NPI Number | 1104152024 |
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Provider Enumeration Date | 10/28/2009 |
Last Update Date | 07/10/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104152024 | NPI | - | NPPES |
5913612 | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (North Carolina) | Secondary |
Copperfield Medical Center, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Mocksville Ave, Salisbury, NC 28144 Phone: 704-633-7220 Fax: 704-647-0515 | |