Individual
DR. JOSEPH LOCICERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
251 N BAYOU ST, MOBILE, AL 36603-5827
(251) 690-8158
(251) 544-2188
Mailing address
1158 CHURCH ST, MOBILE, AL 36604-2936
(251) 432-4373
(251) 432-4142
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD 24943
AL
208600000X
Surgery Physician
60 241117
NY
2086X0206X
Surgical Oncology Physician
60 241117
NY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
60 241117
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011846
MEDICARE GROUP PAYEE NUMBER
AL
01
—
1063439065
MAIN GROUP NPI PAYEE NUMBER
AL
05
—
630000013
—
AL
Enumeration date
07/28/2006
Last updated
09/11/2013
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