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NPI Code Detail

MEDICARE: LORI ANN RICKLEFS D.O.

MEDICARE: LORI ANN RICKLEFS D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician2013-01706NC

General Provider Information

NPI Number : 1376864199
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI ANN RICKLEFS D.O.
Provider Business Mailing Address
First Line : 1021 DARRINGTON DR STE 101
Second Line :
City : CARY
State : NC
Zip : 27513-8158
Country : US
Telephone Number : 849-333-2741
Fax Number : 919-378-9114
Provider Business Practice Location Address
First Line : 804 ENGLISH RD STE 100
Second Line :
City : ROCKY MOUNT
State : NC
Zip : 27804-6027
Country : US
Telephone Number : 252-443-3133
Fax Number : 252-443-0847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/16/2010
Last Update Date : 10/12/2021

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Directions to “ LORI ANN RICKLEFS D.O.” Practice Location

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