Individual
DR. THOMAS LEE WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2100 W IOWA AVE, CHICKASHA, OK 73018-2736
(405) 224-2100
(405) 779-2896
Mailing address
2100 W IOWA AVE, CHICKASHA, OK 73018-2736
(405) 224-2100
(405) 779-2896
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
239
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200029530A
—
OK
Enumeration date
11/11/2005
Last updated
08/16/2016
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