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General NPI Number Information
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NPI Number | 1023941770
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Entity Type | Organization
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Legal Business Name | JOHN WIRICK MD A PROFFESSIONAL LLC
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 2200 VICTORY PKWY STE 602
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City | CINCINNATI
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State | OH
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Zip | 45206-2837
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Country | US
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Telephone | 419-460-1539
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 DAYTON AVE
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City | DAYTON
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State | KY
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Zip | 41074-1602
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Country | US
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Telephone | 419-460-1539
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. JOHN WILLIAM WIRICK
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Credential | MD
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Telephone | 419-460-1539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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