Healthcare Provider Details

I. General information

NPI: 1588653299
Provider Name (Legal Business Name): GENE R FLICK MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 07/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 WASHINGTON AVE STE E
EVANSVILLE IN
47715-4863
US

IV. Provider business mailing address

PO BOX 3276
EVANSVILLE IN
47731-3276
US

V. Phone/Fax

Practice location:
  • Phone: 812-469-2040
  • Fax: 812-469-2042
Mailing address:
  • Phone: 812-473-0181
  • Fax: 812-473-5822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: GENE R FLICK
Title or Position: PRESIDENT
Credential: MD
Phone: 812-469-2040