Ricks, Kevin Mark

Ricks, Kevin Mark is an individual health care provider with primary practice located at 1990 Industrial Boulevard , Houma LA 70363-7055. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Ricks, Kevin Mark can be contacted via phone (985) 868-9300.

Contact Information

Primary practice address
1990 Industrial Boulevard Houma LA 70363-7055
Phone: (985) 868-9300
Fax: (985) 851-0053
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X A10312RX Louisiana

Profile Details

NPI number 1104867258
LBN Legal business name Ricks, Kevin Mark
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Jun 8th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104867258 NPPES
Louisiana MEDICAID 1626759

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