Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KARL THEODORE WICKSTROM, M.D.
ActiveKARL THEODORE WICKSTROM, M.D. is a Diagnostic Radiology healthcare provider located in PRESCOTT, Arizona. NPI 1669476123 is currently active in the NPPES registry. Verify at CMS.
Diagnostic Radiology · PRESCOTT, AZ
Registration Details
- NPI Number
- 1669476123
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 10, 2005 (21.148114316536 yrs)
- Last Updated
- Feb 28, 2013
- License
-
21726 (AZ)
Practice Information
- Address
-
790 GAIL GARDNER WAYPRESCOTT, AZ, 863052337Browse AZ providers · Browse ZIP 86305
- Phone
- 9287769900
- Fax
- 9287761444
- Primary Specialty
-
Diagnostic Radiology
2085R0202X
Other Diagnostic Radiology Providers in PRESCOTT, AZ
| Name | Credential | NPI |
|---|---|---|
| TIMOTHY D OLTHOFF | DO | 1225019425 |
| PATRICK K HITCHCOCK | MD | 1477533776 |
| DAVID K LLOYD | MD | 1932171618 |
| AYAD K AGHA | D.O. | 1730113903 |
| DR. BERNARD SAKOWICZ | M.D. | 1235236589 |
| DR. MARY M PONCEL | M.D. | 1609960707 |
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.