Organization
WOLFCHASE FAMILY MEDICAL CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN R WICKMAN MD, MPH (OWNER)
(901) 377-3001
Entity
Organization
Contact information
Practice address
8485 US HIGHWAY 64 STE 101, MEMPHIS, TN 38133-4102
(901) 377-3001
(901) 377-3130
Mailing address
8485 US HIGHWAY 64 STE 101, MEMPHIS, TN 38133-4102
(901) 377-3001
(901) 377-3130
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
12858
TN
261QP2300X
Primary Care Clinic/Center
Primary
22064
TN
Other
Enumeration date
11/04/2010
Last updated
11/04/2010
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