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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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