Timothy L Ickes PA-C

NPI 1255585790 - Physician Assistant - 363A00000X

NPI Details
NPI 1255585790
Gender Male
Enumeration Date 11/11/2008
Last Updated 05/01/2014
Entity Type Individual
Active Over 8 years ago
Practice Location
2447 MAPLE AVENUE
ZANESVILLE OH, 43701, US
Phone (740) 454-9000
Fax (740) 454-0909
Business Location
224 CHESTNUT STREET
COSHOCTON OH, 43812, US
Phone (740) 622-2000
Fax (740) 622-0419
Toxanomy
Taxonomy Code 363A00000X
License State Ohio
License Number 50-002830
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According to our database, Mr. Timothy L Ickes PA-C NPI is 1255585790, taxonomy code is 363A00000X and license number is 50-002830, license state is located at Ohio. Timothy L Ickes PA-C physically located at 2447 Maple Avenue, Zanesville OH, 43701. NPI Number Timothy L Ickes PA-C has the Individual type.

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1255585790 NPI number is provided on an as is basis without warranty of any kind. 1255585790 is maintained by the National Plan & Provider Enumeration System. The contents of Timothy L Ickes PA-C are for informational purposes only.