Provider Demographics
NPI:1083936793
Name:B.T. STRICK, P.A.
Entity Type:Organization
Organization Name:B.T. STRICK, P.A.
Other - Org Name:MAPLE CREEK MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:STRICKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-563-0300
Mailing Address - Street 1:139 GAIUS ST
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-1508
Mailing Address - Country:US
Mailing Address - Phone:419-563-0300
Mailing Address - Fax:419-563-0500
Practice Address - Street 1:139 GAIUS ST
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-1508
Practice Address - Country:US
Practice Address - Phone:419-563-0300
Practice Address - Fax:419-563-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-22
Last Update Date:2010-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35068424S207R00000X
OH35083452S207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G55117Medicare UPIN
B71118Medicare UPIN