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General NPI Number Information
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NPI Number | 1508918293
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Entity Type | Organization
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Legal Business Name | CHRISTOPHERSON FAMILY MEDICINE, LLC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 02/22/2016
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Provider Practice Location Address
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Address Line | 319 PENNY LN
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City | CONCORD
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State | NC
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Zip | 28025-1221
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Country | US
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Telephone | 704-403-2680
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Fax | 704-784-4346
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Provider Business Mailing Address
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Address Line | 319 PENNY LN
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City | CONCORD
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State | NC
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Zip | 28025-1221
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Country | US
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Telephone | 704-403-2680
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Fax | 704-784-4346
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Authorized Official
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Title or Position | SR. VICE PRESIDENT
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Name | THOMAS F LAYMON
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Credential |
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Telephone | 704-403-2276
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34832
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License Number State | NC
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