Organization
KIDZCARE PEDIATRICS, PC
Active
Other names
Pediatric Associates, PC
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTAE RENEE LOCKHART (CREDENTIALS MANAGER)
(910) 483-7337
Entity
Organization
Contact information
Practice address
145 W MAIN ST, SANFORD, NC 27332-5919
(919) 775-7337
(919) 775-1525
Mailing address
PO BOX 9219, FAYETTEVILLE, NC 28311-9082
(910) 483-7337
(910) 483-0648
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
016VR
BCBS OF NC
NC
05
—
5921254
—
NC
Enumeration date
08/13/2012
Last updated
08/27/2021
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