Individual
JASON G FIKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
5221 US ROUTE 60 E, HUNTINGTON, WV 25705-2022
(304) 522-1550
(304) 522-0704
Mailing address
PO BOX 910, HUNTINGTON, WV 25712-0910
(304) 522-1550
(304) 522-0704
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
888
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719715
MOUNTAIN STATE BCBS
WV
01
—
50024418
PASSPORT
KY
01
—
550493376 00
WV WORKER'S COMPENSATION
WV
05
—
7100052090
—
KY
01
—
P00721065
RR MEDICARE (WV)
WV
Enumeration date
06/18/2006
Last updated
01/08/2010
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