Provider Demographics
NPI:1518164557
Name:QUICK, BRIAN A (PA)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:A
Last Name:QUICK
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37822 US HIGHWAY 18
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE DU CHIEN
Mailing Address - State:WI
Mailing Address - Zip Code:53821-8416
Mailing Address - Country:US
Mailing Address - Phone:608-357-2430
Mailing Address - Fax:608-357-2254
Practice Address - Street 1:37822 US HIGHWAY 18
Practice Address - Street 2:
Practice Address - City:PRAIRIE DU CHIEN
Practice Address - State:WI
Practice Address - Zip Code:53821-8416
Practice Address - Country:US
Practice Address - Phone:608-357-2500
Practice Address - Fax:608-357-2254
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2169363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical