Healthcare Provider Details

I. General information

NPI: 1689006116
Provider Name (Legal Business Name): DLP PERSON PHYSICIAN PRACTICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2013
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 RIDGE RD
ROXBORO NC
27573-4629
US

IV. Provider business mailing address

PO BOX 561
ROXBORO NC
27573-0561
US

V. Phone/Fax

Practice location:
  • Phone: 336-503-5777
  • Fax: 336-503-5705
Mailing address:
  • Phone: 336-503-5811
  • Fax: 336-322-1819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLOTTE LAWRENCE
Title or Position: SECARTERY
Credential:
Phone: 615-920-7000