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Organization

NICHOLAS L. RICO, M.D., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICHOLAS L. RICO M.D. (PRESIDENT AND CEO)
(260) 483-4260
Entity
Organization

Contact information

Practice address
3303 TRIER RD STE 1, FORT WAYNE, IN 46815-4768
(260) 483-4260
(260) 483-6066
Mailing address
3303 TRIER RD STE 1, FORT WAYNE, IN 46815-4768
(260) 483-4260
(260) 483-6066

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01031164A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100079790A
IN
Enumeration date
10/26/2006
Last updated
12/08/2009
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