Provider Demographics
NPI:1215029905
Name:KRICKO, MICHAEL J (DO)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:KRICKO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-7700
Mailing Address - Country:US
Mailing Address - Phone:603-526-5259
Mailing Address - Fax:603-526-5290
Practice Address - Street 1:11 JOHN STARK HWY
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:NH
Practice Address - Zip Code:03773-1807
Practice Address - Country:US
Practice Address - Phone:603-863-4100
Practice Address - Fax:603-863-8074
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS13691207R00000X
NH22549207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3133928Medicaid
NJP413128OtherOXFORD
NJKR778207Medicare ID - Type Unspecified
NJP413128OtherOXFORD