MEDICARE: CRICK & FIFE, L.L.P.

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	208000000X	Pediatrics Physician	22605	KY
2	208000000X	Pediatrics Physician	35996	KY
3	208000000X	Pediatrics Physician	3094P	KY
4	208000000X	Pediatrics Physician	20235	KY

Other Identifiers

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

General Provider Information

NPI Number	:	1649390584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRICK & FIFE, L.L.P.

Provider Business Mailing Address
First Line	:	110 3RD ST STE 180
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-5808
Country	:	US
Telephone Number	:	270-827-3573
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 3RD ST STE 180
Second Line	:
City	:	HENDERSON
State	:	KY
Zip	:	42420-5808
Country	:	US
Telephone Number	:	270-827-3573
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LARRY GEORGE CRICK
Credential	:	M.D.
Telephone Number	:	270-827-3573

Provider Enumeration Date	:	03/31/2007
Last Update Date	:	04/16/2010

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Directions to “CRICK & FIFE, L.L.P. ” Practice Location

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