| Statesville Hma Medical Group, Llc | |
|
35 Ruritan Park Rd Stony Point NC 28678-8928 | |
| (704) 585-9373 | |
| (704) 585-9397 |
| Full Name | Statesville Hma Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 35 Ruritan Park Rd, Stony Point, North Carolina |
| Authorized Official Name and Position | Jennifer L Jackson (SR DIR PROV ENROLLMENT & ONBAORDING) |
| Authorized Official Contact | 6154653334 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Statesville Hma Medical Group, Llc 4000 Meridian Blvd Franklin TN 37067-6325 Ph: (615) 465-7230 | Statesville Hma Medical Group, Llc 35 Ruritan Park Rd Stony Point NC 28678-8928 Ph: (704) 585-9373 |
| NPI Number | 1548796584 |
|---|---|
| Provider Enumeration Date | 05/11/2017 |
| Last Update Date | 01/14/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548796584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 101815 (North Carolina) | Primary |