Organization
MITCHELL WICKER., JR., M.D., P.S.C.
Active
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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