Provider Demographics
NPI:1861493041
Name:GIDDINGS, JOSEPH E III (PA)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:E
Last Name:GIDDINGS
Suffix:III
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 540
Mailing Address - Street 2:
Mailing Address - City:SCOTLAND NECK
Mailing Address - State:NC
Mailing Address - Zip Code:27874-0540
Mailing Address - Country:US
Mailing Address - Phone:252-826-3143
Mailing Address - Fax:252-826-3110
Practice Address - Street 1:919 JR HIGH SCHOOL RD
Practice Address - Street 2:
Practice Address - City:SCOTLAND NECK
Practice Address - State:NC
Practice Address - Zip Code:27874-1219
Practice Address - Country:US
Practice Address - Phone:252-826-3143
Practice Address - Fax:252-826-3110
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101092363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCR43631Medicare UPIN
NC2748450AMedicare ID - Type UnspecifiedMEDICARE