| NPI | 1417962150 |
|---|---|
| Doing Business As | SOUTHFORK MEDICAL PARK |
| Entity Type | Organization |
| Authorized Contact | KAREN SHADOWENS CFO 336-627-8512 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208000000X Pediatrics | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2023-06-16 |