| NPI | 1710261151 |
|---|---|
| Doing Business As | STATESVILLE OBGYN |
| Entity Type | Organization |
| Authorized Contact | JENNIFER L JACKSON Sr Dir Prov Enrollment & Onboarding 615-465-3334 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2022-01-14 |