Healthcare Provider Details

I. General information

NPI: 1548544802
Provider Name (Legal Business Name): DLP PERSON PHYSICIAN PRACTICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2011
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 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: 336-599-5754
  • Fax: 336-599-0069
Mailing address:
  • Phone: 336-599-5754
  • Fax: 336-599-0069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateNC

VIII. Authorized Official

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