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General NPI Number Information
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NPI Number | 1346358843
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Entity Type | Individual
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Provider Name | JOHN WAYNE FRICKER JR. DPM
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Gender | Male
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Dates
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Enumeration Date | 08/26/2006
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Last Update Date | 11/11/2023
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Provider Practice Location Address
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Address Line | 110 DIAGNOSTIC DR STE A
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City | FRANKFORT
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State | KY
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Zip | 40601-6557
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Country | US
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Telephone | 502-219-7937
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Fax | 502-219-7948
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Provider Business Mailing Address
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Address Line | 110 DIAGNOSTIC DR STE A
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City | FRANKFORT
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State | KY
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Zip | 40601-6557
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Country | US
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Telephone | 502-219-7937
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Fax | 502-219-7948
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 246
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 213EP1101X
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Taxonomy Name | Primary Podiatric Medicine Podiatrist
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License Number | 00246
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 244150
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License Number State | KY
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