Organization
GARY WIKERT MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GALE ANN WIKERT (OFFICE MANAGER)
(931) 707-5313
Entity
Organization
Contact information
Practice address
29 TAYLOR AVE, SUITE 210, CROSSVILLE, TN 38555-4527
(931) 707-5313
Mailing address
29 TAYLOR AVE, SUITE 210, CROSSVILLE, TN 38555-4527
(931) 707-5313
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
34776
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3735040
—
TN
01
—
D31365
UPIN
TN
01
—
POO906801
RR MCR
TN
Enumeration date
08/03/2006
Last updated
10/03/2012
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