Provider Demographics
NPI:1447234570
Name:KITELEY, REX ALLISON II (MD)
Entity Type:Individual
Prefix:DR
First Name:REX
Middle Name:ALLISON
Last Name:KITELEY
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 4574
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28406-1574
Mailing Address - Country:US
Mailing Address - Phone:910-251-1839
Mailing Address - Fax:910-251-8286
Practice Address - Street 1:1988 S 16TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6647
Practice Address - Country:US
Practice Address - Phone:910-662-8440
Practice Address - Fax:910-795-4826
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2022-03-01
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Provider Licenses
StateLicense IDTaxonomies
NC2001002522085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC91076BMedicare UPIN