Basic Information
| Provider Information | |||||||||
| NPI: | 1376538165 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FRICKS | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2548 | ||||||||
| Address2: | |||||||||
| City: | ALBANY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 317022548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2293125870 | ||||||||
| FaxNumber: | 2293125853 | ||||||||
| Practice Location | |||||||||
| Address1: | 2336 DAWSON RD | ||||||||
| Address2: | STE 1500 | ||||||||
| City: | ALBANY | ||||||||
| State: | GA | ||||||||
| PostalCode: | 317072442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2293128800 | ||||||||
| FaxNumber: | 2293128895 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 052352 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.