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Individual
JERRY ANDREW FIKES
Active
Individual
JERRY ANDREW FIKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD MAGD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3162
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51506076
BLUE CROSS BLUE SHIELD
AL
Enumeration date
10/17/2006
Last updated
07/08/2007
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