Organization
OTTO W WICKSTROM JR. M.D. INC.
Active
Organization
OTTO W WICKSTROM JR. M.D. INC.
Active
Other names
Otto W Wickstrom Jr. M.D. Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OTTO W WICKSTROM M.D. (PHYSICIAN)
(812) 372-2437
Entity
Organization
Contact information
Practice address
2360 N NATIONAL RD, COLUMBUS, IN 47201-3732
(812) 372-2437
(812) 379-2621
Mailing address
2360 N NATIONAL RD, COLUMBUS, IN 47201-3732
(812) 372-2437
(812) 379-2621
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01018161A
IN
Other
Enumeration date
02/20/2007
Last updated
08/22/2020
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