Healthcare Provider Details

I. General information

NPI: 1568717072
Provider Name (Legal Business Name): RICKEY BASKETT JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9768 HOLLY SPRINGS ROAD
APEX NC
27539
US

IV. Provider business mailing address

9768 HOLLY SPRINGS ROAD
APEX NC
27539
US

V. Phone/Fax

Practice location:
  • Phone: 919-599-0988
  • Fax: 919-504-9243
Mailing address:
  • Phone: 919-599-0988
  • Fax: 919-504-9243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2015-01395
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: