Provider Demographics
NPI:1548221484
Name:SHILKITUS, WILLIAM FRANCIS (PAC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANCIS
Last Name:SHILKITUS
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7473-C HWY 22
Mailing Address - Street 2:
Mailing Address - City:WHISPERING PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28327-8514
Mailing Address - Country:US
Mailing Address - Phone:910-215-5100
Mailing Address - Fax:
Practice Address - Street 1:4565 FAYETTEVILLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-7998
Practice Address - Country:US
Practice Address - Phone:910-878-5100
Practice Address - Fax:910-878-5140
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA002144L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S49359Medicare UPIN