Individual
DR. RICKY R MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1600 1ST ST E, INDEPENDENCE, IA 50644-3155
(319) 334-2541
(319) 334-7054
Mailing address
1600 1ST ST E, INDEPENDENCE, IA 50644-3155
(319) 334-2541
(319) 334-7054
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3577
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0414631
—
IA
Enumeration date
07/07/2005
Last updated
01/07/2021
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