Provider Demographics
NPI:1134210610
Name:VICK, WILLIAM DORSEY III (RPH)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DORSEY
Last Name:VICK
Suffix:III
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:504 N FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27801-6257
Mailing Address - Country:US
Mailing Address - Phone:252-977-1202
Mailing Address - Fax:
Practice Address - Street 1:504 N FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27801-6257
Practice Address - Country:US
Practice Address - Phone:252-977-1202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC06394183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist