Organization
MOORE COUNTY ANESTHESIA ASSOCIATES DR JOSEPH B WICKER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH BEAMAN WICKER MD (PRESIDENT)
(910) 295-2920
Entity
Organization
Contact information
Practice address
155 MEMORIAL DR, PINEHURST, NC 28374-8710
(910) 295-2920
(910) 295-4640
Mailing address
45 CANTER LN, PO BOX 5249, PINEHURST, NC 28374-8666
(910) 295-2920
(910) 295-4640
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
26166
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050085497
RAILROAD MEDICARE
NC
01
—
2322696
MEDICARE GROUP NUMBER
NC
05
—
8987269
—
NC
05
—
Q26166
—
SC
Enumeration date
12/13/2007
Last updated
01/05/2012
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