Individual
JERICK C PACHECO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
528 N 1ST ST, VINCENNES, IN 47591-1402
(812) 882-4434
(812) 885-6318
Mailing address
528 N 1ST ST, VINCENNES, IN 47591-1402
(812) 882-4434
(812) 885-6318
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01063831A
IN
208000000X
Pediatrics Physician
35081844P
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200869750A
—
IN
Enumeration date
12/20/2005
Last updated
09/07/2012
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