Healthcare Provider Details

I. General information

NPI: 1427680768
Provider Name (Legal Business Name): MOSES CONE PHYSICIAN SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2020
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 VIRGINIA ST
GREENSBORO NC
27401-1313
US

IV. Provider business mailing address

PO BOX 745040
ATLANTA GA
30374-5040
US

V. Phone/Fax

Practice location:
  • Phone: 336-275-0927
  • Fax: 336-275-4834
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: SALLY HAMMOND
Title or Position: EXECUTIVE DIRECTOR, OPERATIONS
Credential:
Phone: 336-663-5007