Provider Demographics
NPI:1447026521
Name:FRICKER FOOT CLINIC PLLC
Entity type:Organization
Organization Name:FRICKER FOOT CLINIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:FRICKER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:502-545-2762
Mailing Address - Street 1:1241 MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-4573
Mailing Address - Country:US
Mailing Address - Phone:502-545-2762
Mailing Address - Fax:
Practice Address - Street 1:110 DIAGNOSTIC DR STE A
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-6557
Practice Address - Country:US
Practice Address - Phone:502-219-7937
Practice Address - Fax:502-219-7948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty