NPI 1013291442

Statesville Hma Medical Group, LLC

Organisation Urology Physician Statesville, NC

Practice location

Address: 1424 Fern Creek Dr Suite B, Statesville, NC 28625-9376
Phone: (704) 662-9870
Fax: (704) 662-9788
Mailing address: 4000 Meridian Blvd, Franklin, TN 37067-6325

Authorised official

Name: Jennifer L Jackson
Title: Sir Dir Prov Enrollment & Onboardin
Phone: (615) 465-3334

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X

Other Urology providers in North Carolina →

Registry record

NPI: 1013291442
Entity type: Organization
NPI issued: 4 Oct 2011
Record last updated: 14 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.