1508855347

Everything you always wanted to know about FICKLING B KENNETH MD but were afraid to ask.

FICKLING B KENNETH MD

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Provider Last Name Provider Middle Name Provider First Name Provider Credential
FICKLING B KENNETH MD
Gender:
Male
Enumeration date:
2005-10-14
Last update date:
2007-07-08
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
F97884 Medicare UPIN none none

Taxonomies

Taxonomy State License Number Primary?
207L00000X Anesthesiology NY 198225

Phone Numbers

Type Number
Mailing Address Fax Number 3154452936
Mailing Address Telephone Number 3154490513
Practice Location Address Telephone Number 5852558966

Addresses

Type Address City State Postal Country
Mailing Address PO BOX 2005 EAST SYRACUSE NY 13057 NY
Practice Location Address 1555 LONG POND RD ROCHESTER NY 14626 NY

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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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