Individual
WILLIAM JOSEPH LICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308
(404) 686-3845
Mailing address
4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 835-9880
(952) 857-1554
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
61361
CT
207P00000X
Emergency Medicine Physician
Primary
70308
MN
207P00000X
Emergency Medicine Physician
82768
GA
Other
Enumeration date
04/24/2015
Last updated
10/10/2021
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