Individual
JACOB C FRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 W KK RIVER PKWY, SUITE 930, MILWAUKEE, WI 53215-3669
(414) 384-5111
Mailing address
3003 W GOOD HOPE RD, MILWAUKEE, WI 53209-2042
(414) 352-3100
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
23052
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30591100
—
WI
01
—
P00823722
RR MEDICARE
WI
Enumeration date
11/03/2005
Last updated
06/18/2010
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