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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

ALVAH TYSON WICKBOLDT JR., M.D.

Active

ALVAH TYSON WICKBOLDT JR., M.D. is a Vascular Surgery healthcare provider located in NEW ORLEANS, Louisiana. NPI 1083971006 is currently active in the NPPES registry. Verify at CMS.

Vascular Surgery · NEW ORLEANS, LA

Registration Details

NPI Number
1083971006
Provider Type
Individual
Gender
Male
NPI Issued
Apr 15, 2012 (14.347431016584 yrs)
Last Updated
Jul 21, 2022
License
305062 (LA)

Practice Information

Address
1514 JEFFERSON HWY
BRENT HOUSE ROOM 634
NEW ORLEANS, LA, 701212429
Browse LA providers · Browse ZIP 70121
Phone
5048423000
Primary Specialty
Vascular Surgery
208VP0000X
Additional Specialty
Vascular Surgery

Other Vascular Surgery Providers in NEW ORLEANS, LA

Name Credential NPI
TREVOR JACOB JOHNSON MD 1023501707
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.