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NPI Code Detail

MEDICARE: CAROLINAS PHYSICIANS NETWORK INC

MEDICARE: CAROLINAS PHYSICIANS NETWORK INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1225268170
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAROLINAS PHYSICIANS NETWORK INC
Provider Business Mailing Address
First Line : PO BOX 19305
Second Line :
City : CHARLOTTE
State : NC
Zip : 28219-9305
Country : US
Telephone Number : 704-631-0002
Fax Number :
Provider Business Practice Location Address
First Line : 123 PROFESSIONAL PARK DR
Second Line :
City : LOCUST
State : NC
Zip : 28097-7712
Country : US
Telephone Number : 704-403-6760
Fax Number :
Authorized Official
Title or Position : ENTERPRISE EVP
Name : SCOTT RISSMILLER
Credential :
Telephone Number : 704-355-8675
Provider Enumeration Date : 07/24/2009
Last Update Date : 03/09/2023

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Directions to “CAROLINAS PHYSICIANS NETWORK INC ” Practice Location

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