Individual
MR. JOHN C. WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7910 US HIGHWAY 117 S, SUITE 120, ROCKY POINT, NC 28457-7409
(910) 259-0400
(910) 675-3030
Mailing address
PO BOX 602484, CHARLOTTE, NC 28260-2484
(910) 259-0400
(910) 259-0400
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06043
NC
363A00000X
Physician Assistant
MA002111L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1316998347
—
NC
05
—
2533PA
—
SC
Enumeration date
05/15/2006
Last updated
11/23/2016
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