Statesville Hma Medical Group, LLC

NPI #1639407737 in Statesville, North Carolina

Provider Information

NPI Number
1639407737
Entity Type
Organization
Organization Name
Statesville Hma Medical Group, LLC
Subpart
Yes (part of a larger organization)
Parent Organization
STATESVILLE HMA MEDICAL GROUP LLC
Primary Specialty
Family Medicine
Enumeration Date
Dec 1, 2009
Last Updated
Jan 14, 2022

Practice Location

Address
1412 FERN CREEK DR
ZIP Code
28625-9376
Phone
(704) 660-4145

Authorized Official

Name
MRS. JENNIFER L JACKSON
Title
SR DIR PROV ENROLLMENT & ONBOARDING
Phone
(615) 465-3334

Specialties & Taxonomy Codes

Specialty
Family Medicine

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