# DR. DALE WICKSTROM-HILL PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174621114
- **Authorized official:** DR. DALE WICKSTROM-HILL DO (MD/PRESIDENT)
- **Authorized official phone:** (352) 867-8898

## Contact information

- **Practice address:** 200 AVENUE F NE, WINTER HAVEN, FL 33881-4131
- **Practice address phone:** (352) 867-8898
- **Practice address fax:** (352) 732-6282
- **Mailing address:** PO BOX 198096, ATLANTA, GA 30384-8096
- **Mailing address phone:** (352) 867-8898
- **Mailing address fax:** (866) 665-2702

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | OS0006374 | FL | Yes |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 04/11/2014