Individual
DR. JEFFREY WICKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
464 LINDEN AVE, HARRODSBURG, KY 40330-1882
(859) 734-5441
(859) 734-5563
Mailing address
1973 FAVELL CT, LEXINGTON, KY 40503-4005
(859) 272-2364
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25976
KY
207Q00000X
Family Medicine Physician
25976
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64259765
—
KY
Enumeration date
06/15/2006
Last updated
12/16/2020
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