| Organization Name: | INTEGRATED CARE CLINICS, PA |
| NPI Number: | 1396775110 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BILL E MICKLE (OWNER) |
| Mailing Address: | 29 Lake Street South Big Lake |
| State: | MN US |
| Postal Code: | 553090277 |
| Phone Number: | 7632638401 |
| Fax Number: | 7632635900 |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 11/04/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207LP2900X |
| License Number: | 44760 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Anesthesiology |
| Taxonomy Specialization: | Pain Medicine |
| Taxonomy Definition: | An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |