Provider Demographics
NPI:1720386220
Name:UNC PHYSICIANS NETWORK, LLC
Entity Type:Organization
Organization Name:UNC PHYSICIANS NETWORK, LLC
Other - Org Name:UNC URGENT CARE AT CAROLINA POINTE II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMO
Authorized Official - Prefix:
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:FISCUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:984-215-4111
Mailing Address - Street 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6013 FARRINGTON RD
Practice Address - Street 2:SUITE #101
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8172
Practice Address - Country:US
Practice Address - Phone:919-957-6610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5918684Medicaid
NC5918684Medicaid