Diane a Schlick DO LLC

Organization Active NPI Family Medicine Physician · Perry, FL

NPI 1205943164 · NPPES record last updated Aug 2, 2007

Key facts

NPI
1205943164
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
OS7860 (FL)
Legal business name
DIANE A SCHLICK DO LLC
Practice address
616 S Jefferson St
Perry, FL 32347-4115
Phone
(850) 584-5876
Fax
(850) 584-4939
NPI assigned
Aug 24, 2006
Organization subpart
No

Authorized official

Name
Diane A Schlick, DO
Title
Proprieter
Phone
(850) 584-5876

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X OS7860 FL Yes

Addresses

Primary practice location

616 S Jefferson St
Perry, FL 32347-4115

Mailing address

616 S Jefferson St
Perry, FL 32347-4115
Phone (850) 584-5876

Other identifiers

IdentifierTypeStateIssuer
256619200MedicaidFL

Other names

  • Diane A. Haisten, DO, LLC Former legal business name

Other providers in Perry, FL

All providers in Perry, FL · Family Medicine Physician in Florida

Sources for this page

Verify at the official NPI Registry.