Individual
ALLAN BENJAMIN WICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1230 E 1ST ST, CASPER, WY 82601-2704
(307) 266-3174
(307) 261-6713
Mailing address
1230 E 1ST ST, CASPER, WY 82601-2704
(307) 266-3174
(307) 261-6713
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
6146A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034644
BCBS
WY
01
—
060050550
RAILROAD MEDICARE
WY
05
—
113648800
—
WY
01
—
304682
BLUE SHIELD
WY
Enumeration date
05/31/2006
Last updated
06/06/2008
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