MEDICARE: ALICIA MARIE PAXSON PA-C

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
1	363AM0700X	Medical Physician Assistant	PA9102154	FL
2	363A00000X	Physician Assistant	PA9102154	FL
3	363AM0700X	Medical Physician Assistant	0010-10288	NC
4	363A00000X	Physician Assistant	0010-10288	NC

General Provider Information

NPI Number	:	1366438111
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALICIA MARIE PAXSON PA-C

Provider Business Mailing Address
First Line	:	415 N CENTER ST STE 300
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-5036
Country	:	US
Telephone Number	:	828-328-3300
Fax Number	:	828-328-9101

Provider Business Practice Location Address
First Line	:	415 N CENTER ST STE 300
Second Line	:
City	:	HICKORY
State	:	NC
Zip	:	28601-5036
Country	:	US
Telephone Number	:	828-328-3300
Fax Number	:	828-328-9101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2005
Last Update Date	:	05/21/2021

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Directions to “ ALICIA MARIE PAXSON PA-C” Practice Location

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