Individual
DR. TODD A WICAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 412-1411
(270) 412-6802
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 412-1411
(270) 412-6802
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
1204
NE
207P00000X
Emergency Medicine Physician
Primary
04424
KY
207Q00000X
Family Medicine Physician
04424
KY
207Q00000X
Family Medicine Physician
1204
NE
207Q00000X
Family Medicine Physician
3503
TN
2083A0100X
Aerospace Medicine Physician
1204
NE
Other
Enumeration date
06/23/2013
Last updated
09/13/2024
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