Individual
JOSHUA SCOTT RICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-3813
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2015-00195
NC
208600000X
Surgery Physician
LL32641
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164742748
—
NC
05
—
NC2425
—
SC
Enumeration date
06/07/2010
Last updated
10/25/2020
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