Provider Demographics
NPI:1063725307
Name:O'KICKI, LETITIA ANN (MD)
Entity type:Individual
Prefix:
First Name:LETITIA
Middle Name:ANN
Last Name:O'KICKI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1350 EDGMONT AVE
Mailing Address - Street 2:STE 1500
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3962
Mailing Address - Country:US
Mailing Address - Phone:610-690-4490
Mailing Address - Fax:610-328-9391
Practice Address - Street 1:1260 E WOODLAND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3969
Practice Address - Country:US
Practice Address - Phone:610-690-4490
Practice Address - Fax:610-328-9391
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-15
Last Update Date:2018-09-12
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Provider Licenses
StateLicense IDTaxonomies
PAMD030845E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine