Organization
MITCHELL WICKER., JR., M.D., P.S.C.
Active
Other names
Hazard Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MITCHELL WICKER JR. M.D. (OWNER)
(606) 439-1316
Entity
Organization
Contact information
Practice address
271 EAST MAIN STREET, HAZARD, KY 41701
(606) 439-1316
(606) 439-4224
Mailing address
PO BOX 719, HAZARD, KY 41702
(606) 439-1316
(606) 439-4224
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21790
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65915910
—
KY
Enumeration date
03/19/2008
Last updated
08/11/2008
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