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General NPI Number Information
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NPI Number | 1255353298
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Entity Type | Organization
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Legal Business Name | PORT CITY ORTHOPAEDICS PLLC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 206 CAUSEWAY DR UNIT 232
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City | WRIGHTSVILLE BEACH
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State | NC
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Zip | 28480-1759
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Country | US
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Telephone | 910-791-4492
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Fax | --
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Provider Business Mailing Address
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Address Line | CO D HICKEY, PRESIDENT 6101 OLD BRANCH RD
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City | WILMINGTON
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State | NC
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Zip | 28409
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Country | US
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Telephone | 910-791-4492
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Fax | --
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DERRICK GERARD HICKEY
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Credential | MD
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Telephone | 910-791-4492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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