Provider Demographics
NPI:1013973692
Name:STRICKER, JEFFREY B (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:B
Last Name:STRICKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:JEFFREY
Other - Middle Name:B
Other - Last Name:STRICKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:2505 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4423
Mailing Address - Country:US
Mailing Address - Phone:850-233-3376
Mailing Address - Fax:850-522-8354
Practice Address - Street 1:106 WESTSIDE DR
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36303-1908
Practice Address - Country:US
Practice Address - Phone:877-231-3376
Practice Address - Fax:850-522-8354
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2025-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1463207ND0900X, 207ND0101X
FLOS8467207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL102I076050OtherMEDICARE
FL01730VOtherMEDICARE
H44588Medicare UPIN
07BBSQVMedicare ID - Type Unspecified