Provider Demographics
NPI:1093774903
Name:AMICK, RALPH EMERSON JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:RALPH
Middle Name:EMERSON
Last Name:AMICK
Suffix:JR
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:3685 GRANDVIEW RD
Mailing Address - Street 2:
Mailing Address - City:BEAVER
Mailing Address - State:WV
Mailing Address - Zip Code:25813-9291
Mailing Address - Country:US
Mailing Address - Phone:304-255-2121
Mailing Address - Fax:304-256-5159
Practice Address - Street 1:200 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-6444
Practice Address - Country:US
Practice Address - Phone:304-255-2121
Practice Address - Fax:304-256-5159
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2024-04-27
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical