Individual
DR. JOHN O WYCOFF
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1200 E MICHIGAN AVE, SUITE 325, LANSING, MI 48912-1800
(517) 364-5160
(517) 364-5165
Mailing address
1200 E MICHIGAN AVE, SUITE 325, LANSING, MI 48912-1800
(517) 364-5160
(517) 364-5165
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101009308
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0853310114
BCBS PIN NUMBER
MI
05
—
3477253
—
MI
Enumeration date
04/19/2006
Last updated
07/08/2007
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