| William L Rucker, MD | |
|
130 Glendale Dr W, Wilson, NC 27893-2770 | |
| (252) 399-7557 | |
| (252) 399-1324 |
| Full Name | William L Rucker |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 130 Glendale Dr W, Wilson, North Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326034513 | NPI | - | NPPES |
| 8973822 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 26867 (North Carolina) | Primary |
| Entity Name | Vidant Medical Group LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1477648731 PECOS PAC ID: 0345343893 Enrollment ID: O20070321000445 |
| Mailing Address | Practice Location Address |
|---|---|
| William L Rucker, MD 4433 Norris Store Rd, Ayden, NC 28513-8725 Ph: (252) 746-3884 | William L Rucker, MD 130 Glendale Dr W, Wilson, NC 27893-2770 Ph: (252) 399-7557 |
George Coupland Isaacs, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 130 Glendale Dr W, Wilson, NC 27893 Phone: 252-399-7557 Fax: 252-399-1324 |
Deborah Daetwyler Boyd, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 130 Glendale Dr W, Wilson, NC 27893 Phone: 252-399-7557 Fax: 252-399-1324 |
Emil J Cekada, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 130 Glendale Dr W, Wilson, NC 27893 Phone: 252-399-7557 Fax: 252-399-1324 |