Organization
NWIA BONE, JOINT & SPORTS SURGEONS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY DUANE WILKERSON D.O. (PHYSICIAN/OWNER)
(712) 262-7511
Entity
Organization
Contact information
Practice address
1200 1ST AVE E, STE C, SPENCER, IA 51301-4342
(712) 262-7511
(712) 262-3658
Mailing address
1200 1ST AVE E, STE C, SPENCER, IA 51301-4342
(712) 262-7511
(712) 262-3658
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS8940
RAILROAD MEDICARE
IA
Enumeration date
05/24/2005
Last updated
02/16/2016
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