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NPI Code Detail

MEDICARE: TIM FICK AAS-HIS, BC-HIS

MEDICARE:   TIM  FICK  AAS-HIS, BC-HIS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialist2015015579MO
2174400000XSpecialist3239IL

General Provider Information

NPI Number : 1275082406
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIM FICK AAS-HIS, BC-HIS
Provider Business Mailing Address
First Line : 5157 LEMAY FERRY RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63129-1533
Country : US
Telephone Number : 314-487-5550
Fax Number : 314-487-5554
Provider Business Practice Location Address
First Line : 5157 LEMAY FERRY RD
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63129-1533
Country : US
Telephone Number : 314-487-5550
Fax Number : 314-487-5554
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2016
Last Update Date : 09/29/2016

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Directions to “ TIM FICK AAS-HIS, BC-HIS” Practice Location

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