Healthcare Provider Details

I. General information

NPI: 1083936793
Provider Name (Legal Business Name): B.T. STRICK, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2010
Last Update Date: 02/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

139 GAIUS ST
BUCYRUS OH
44820-1508
US

IV. Provider business mailing address

139 GAIUS ST
BUCYRUS OH
44820-1508
US

V. Phone/Fax

Practice location:
  • Phone: 419-563-0300
  • Fax: 419-563-0500
Mailing address:
  • Phone: 419-563-0300
  • Fax: 419-563-0500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35068424S
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number35083452S
License Number StateOH

VIII. Authorized Official

Name: DR. TODD STRICKLAND
Title or Position: PRESIDENT
Credential: M.D.
Phone: 419-563-0300