MEDICARE: LARRY G LIKA DO

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
1	207X00000X	Orthopaedic Surgery Physician	34-00-4797	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00380959	OTHER	OH	RAILROAD MEDICARE
2	20021579	OTHER		RAILROAD MEDICARE
3	P00760393	OTHER	OH	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043279474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LARRY G LIKA DO

Provider Business Mailing Address
First Line	:	PO BOX 378
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44871-0378
Country	:	US
Telephone Number	:	440-842-1570
Fax Number	:	440-842-8230

Provider Business Practice Location Address
First Line	:	15299 BAGLEY RD STE 100
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44130-4823
Country	:	US
Telephone Number	:	440-885-2100
Fax Number	:	440-885-2106

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	12/02/2016

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Directions to “ LARRY G LIKA DO” Practice Location

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