Organization
WILLIAM M. WIXTED M.D., P.C.
Active
Organization
WILLIAM M. WIXTED M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM M. WIXTED MD (DIRECTOR)
(609) 653-0199
Entity
Organization
Contact information
Practice address
731 BAY AVE, SOMERS POINT, NJ 08244-2342
(609) 653-0199
(609) 653-9411
Mailing address
731 BAY AVE, SOMERS POINT, NJ 08244-2342
(609) 653-0199
(609) 653-9411
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
25MA02912900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1336188572
PERSONEL NPI#
NJ
01
—
25MA02912900
LICENSE
NJ
Enumeration date
02/05/2007
Last updated
08/22/2020
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