Individual
DR. RUTH WYCKOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
440 W LAUREL AVE, PLENTYWOOD, MT 59254-1526
(406) 765-3718
Mailing address
405 HOOVER ST, #102, PLENTYWOOD, MT 59254-1735
(210) 428-4503
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
BP10021668
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1992904833
NPI
TX
Enumeration date
07/11/2007
Last updated
03/09/2011
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