Individual
BRIAN WICKERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14540 OLD SAINT AUGUSTINE RD STE 2571, JACKSONVILLE, FL 32258-7420
(904) 886-2251
(904) 886-7151
Mailing address
14540 OLD SAINT AUGUSTINE RD STE 2571, JACKSONVILLE, FL 32258-7420
(904) 886-2251
(904) 886-7151
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME180656
FL
208600000X
Surgery Physician
Primary
R75035
AZ
Other
Enumeration date
05/13/2015
Last updated
04/30/2026
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