Individual
GEORGE J JICHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1800 E FLORENCE BLVD, CASA GRANDE, AZ 85222-5303
(520) 381-6300
(520) 381-6618
Mailing address
6653 MAIN STREET, THE EXIGENCE GROUP C O JANENE FARLEY, WILLIAMSVILLE, NY 14221
(716) 817-2932
(716) 204-4501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2388
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
548745
—
AZ
Enumeration date
02/02/2006
Last updated
08/20/2012
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