Individual
DR. SUZANNE MARIE WICAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(605) 651-4259
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(605) 651-4259
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28269
NE
Other
Enumeration date
04/09/2013
Last updated
03/20/2019
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