Individual
DR. BARRY L DICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
580 S LOOP RD, SUITE 201, EDGEWOOD, KY 41017-3415
(859) 344-1600
(859) 344-0091
Mailing address
2300 CHAMBER CENTER DR, SUITE 200, LAKESIDE PARK, KY 41017-1673
(859) 344-5555
(859) 344-5552
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
29604
KY
208600000X
Surgery Physician
29604
KY
2086S0129X
Vascular Surgery Physician
Primary
29604
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0915148
—
OH
05
—
100354170
—
IN
05
—
64933096
—
KY
05
—
7100056850
—
KY
01
—
P00252704
RAILROAD MEDICARE
—
01
—
P01058472
RAILROAD MEDICARE
KY
Enumeration date
09/26/2005
Last updated
10/01/2015
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