Individual
MR. BOYD ROY WICKIZER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 MEDICAL PARK BLVD, PETERSBURG, VA 23805-9274
(804) 765-5949
(804) 765-6250
Mailing address
PO BOX 446, MIDLOTHIAN, VA 23113-0446
(804) 858-3998
(804) 765-6250
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101047692
VA
208600000X
Surgery Physician
0101047692
VA
Other
Enumeration date
05/09/2006
Last updated
12/23/2009
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