Organization
MITCHELL WICKER JR MD PSC
Active
Organization
MITCHELL WICKER JR MD PSC
Active
Other names
Hazard Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL WICKER JR. MD (OWNER)
(606) 439-1316
Entity
Organization
Contact information
Practice address
271 E MAIN ST, HAZARD, KY 41701-1939
(606) 439-1316
(606) 435-0752
Mailing address
PO BOX 719, HAZARD, KY 41702-0719
(606) 439-1316
(606) 435-0752
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21790
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31001035
—
KY
Enumeration date
05/23/2005
Last updated
01/17/2014
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