Organization
KIDZCARE PEDIATRICS, PC
Active
Other names
Pediatric Associates, PC
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTAE RENEE LOCKHART (CREDENTIALS SPECIALIST)
(910) 483-7337
Entity
Organization
Contact information
Practice address
3115 BORDEAUX PARK DR, FAYETTEVILLE, NC 28306
(910) 307-7337
(910) 323-4620
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
NC
05
—
5908525
—
NC
Enumeration date
05/28/2009
Last updated
08/27/2021
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