Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. OTTO WILLIAM WICKSTROM III, M.D.
ActiveDR. OTTO WILLIAM WICKSTROM III, M.D. is a Orthopaedic Surgery of the Spine healthcare provider located in BLOOMINGTON, Indiana. NPI 1487826939 is currently active in the NPPES registry. Verify at CMS.
Orthopaedic Surgery of the Spine · BLOOMINGTON, IN
Registration Details
- NPI Number
- 1487826939
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 25, 2008 (18.432321523185 yrs)
- Last Updated
- Apr 29, 2021
- Licenses
-
MD61074238 (WA)MD61074238 (WA)01065381A (IN)
Practice Information
- Address
-
583 S CLARIZZ BLVDBLOOMINGTON, IN, 474015515Browse IN providers · Browse ZIP 47401
- Phone
- 8123332663
- Fax
- 8123499206
- Primary Specialty
-
Orthopaedic Surgery of the Spine
207XS0106X
- Additional Specialty
- Orthopaedic Surgery of the Spine
- Additional Specialty
- Specialist
Other Orthopaedic Surgery of the Spine Providers in BLOOMINGTON, IN
| Name | Credential | NPI |
|---|---|---|
| DALE DELLACQUA | M.D. | 1790837938 |
| DR. RAJIH Y HADDAWI | M.D. | 1649598707 |
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.