# WICKMAN FAMILY MEDICAL CARE

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

## Provider details

- **NPI number:** 1245541622
- **Authorized official:** JOHN R. WICKMAN (M.D. M.P.H.)
- **Authorized official phone:** (901) 377-3001

## Contact information

- **Practice address:** 8485 US HIGHWAY 64 STE 101, MEMPHIS, TN 38133-4102
- **Practice address phone:** (901) 377-3001
- **Practice address fax:** (901) 377-3130
- **Mailing address:** 8485 US HIGHWAY 64 STE 101, MEMPHIS, TN 38133-4102
- **Mailing address phone:** (901) 377-3001
- **Mailing address fax:** (901) 377-3130

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/30/2010
- **Last updated:** 06/30/2010