Full Name | |
---|---|
Speciality | Family Medicine |
Location | 216 Moore Rd, King, 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: (704) 417-4634 | 216 Moore Rd King NC 27021-8703 Ph: (336) 983-4346 |
NPI Number | 1497713234 |
---|---|
Provider Enumeration Date | 05/02/2006 |
Last Update Date | 07/11/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1497713234 | NPI | - | NPPES |
CA1315 | Other | NC | RAILROAD MEDICARE |
890224P | Medicaid | NC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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