Organization
BOICE-WILLIS CLINIC PA
Active
Organization
BOICE-WILLIS CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENITA RICHARDSON (REVENUE AND REIMBURSEMENT MANAGER)
(252) 937-0326
Entity
Organization
Contact information
Practice address
901 N WINSTEAD AVE, ROCKY MOUNT, NC 27804-8467
(252) 937-0200
(252) 451-0056
Mailing address
PO BOX 7200, ROCKY MOUNT, NC 27804-0200
(252) 937-0200
(252) 451-0056
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RR0500X
Rheumatology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01122
BCBSNC
NC
05
—
8901122
—
NC
Enumeration date
05/28/2006
Last updated
08/05/2024
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