Provider Demographics
NPI:1275925828
Name:PMC PHYSICIAN NETWORK, L.L.C.
Entity Type:Organization
Organization Name:PMC PHYSICIAN NETWORK, L.L.C.
Other - Org Name:CATAWBA NEUROSURGERY ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL CFO, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:O
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-265-5009
Mailing Address - Street 1:PO BOX 743361
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3361
Mailing Address - Country:US
Mailing Address - Phone:336-776-0386
Mailing Address - Fax:336-774-6919
Practice Address - Street 1:200 S HERLONG AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3399
Practice Address - Country:US
Practice Address - Phone:803-327-8500
Practice Address - Fax:803-327-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-19
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty