Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

William John Edmiston Jr., MD

Individual provider Interventional Pain Medicine Physician · NPI 1053420190

William John Edmiston Jr., MD is a Pain Management in Mooresville, North Carolina. Qualified in 1991, 35 years ago. Practices with Iredell Physician Network LLC, a 89-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
35
Licensed in
NC
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

170 Medical Park Rd Ste 301
Mooresville, NC 28117-8540
Phone: (704) 360-4378
Fax: (704) 696-8150
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Pain Medicine Physician (primary) Taxonomy 208VP0014X · Licence 200000410 (NC)

Record details

NPI number1053420190
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 30, 2006
Last updated in NPPESMarch 7, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPAIN MANAGEMENT
Also practisesANESTHESIOLOGY
Medical schoolOTHER
Graduated 1991 (35 years in practice)
Group practice Iredell Physician Network Llc — 89 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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