MEDICARE: DR. RICK EARL ERICKSON MD

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	207Y00000X	Otolaryngology Physician	K7527	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5078753	OTHER	TX	AETNA ID#
2	0039GS	OTHER	TX	BCBS GROUP #
3	4193431	OTHER	TX	BLUELINK NUMBER
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8	8B5440	OTHER	TX	BCBS PROVIDER #

General Provider Information

NPI Number	:	1457354367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICK EARL ERICKSON MD

Provider Business Mailing Address
First Line	:	1001 E AUSTIN ST
Second Line	:
City	:	PARIS
State	:	TX
Zip	:	75460-7483
Country	:	US
Telephone Number	:	903-785-5800
Fax Number	:	903-785-5821

Provider Business Practice Location Address
First Line	:	1001 E AUSTIN ST
Second Line	:
City	:	PARIS
State	:	TX
Zip	:	75460-7483
Country	:	US
Telephone Number	:	903-785-5800
Fax Number	:	903-785-5821

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	01/23/2013

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