| William John Edmiston Jr, MD | |
|
170 Medical Park Rd, Suite 301, Mooresville, NC 28117-8540 | |
| (704) 360-4378 | |
| (704) 696-8150 |
| Full Name | William John Edmiston Jr |
|---|---|
| Gender | Male |
| Speciality | Pain Management |
| Experience | 34 Years |
| Location | 170 Medical Park Rd, Mooresville, North Carolina |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053420190 | NPI | - | NPPES |
| 891269N | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 200000410 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Iredell Memorial Hospital Inc | Statesville, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Iredell Physician Network Llc | 0749345007 | 71 |
| Entity Name | Iredell Physician Network Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1811381593 PECOS PAC ID: 0749345007 Enrollment ID: O20090219000651 |
| Mailing Address | Practice Location Address |
|---|---|
| William John Edmiston Jr, MD 170 Medical Park Rd, Suite 301, Mooresville, NC 28117-8540 Ph: (704) 360-4378 | William John Edmiston Jr, MD 170 Medical Park Rd, Suite 301, Mooresville, NC 28117-8540 Ph: (704) 360-4378 |
Dr. Patrick Jacques Laguerre, M.D. Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 146 Medical Park Road, Suite 108, Mooresville, NC 28117 Phone: 704-662-0877 Fax: 704-662-0875 | |
Mark C Hines, MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 170 Medical Park Rd, Suite 310, Mooresville, NC 28117 Phone: 704-360-2260 Fax: 704-360-2274 |