Provider Demographics
NPI:1841200250
Name:CRICK, WILLIAM F (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:F
Last Name:CRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 25337
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34277-2337
Mailing Address - Country:US
Mailing Address - Phone:941-917-0060
Mailing Address - Fax:941-316-9216
Practice Address - Street 1:1540 S TAMIAMI TRL
Practice Address - Street 2:SUITE 401
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2940
Practice Address - Country:US
Practice Address - Phone:941-917-0060
Practice Address - Fax:941-316-9216
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME33519207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL060021274OtherRAILROAD MEDICARE
FL209636OtherAVMED
FL4374189OtherAETNA
FL25623OtherWELLCARE
FL58367OtherBLUE CROSS BLUE SHIELD
FL066870200Medicaid
FL066870200Medicaid
FL25623OtherWELLCARE