| Karl Theodore Wickstrom, MD | |
|
790 Gail Gardner Way, Prescott, AZ 86305-2337 | |
| (928) 776-9900 | |
| (928) 776-1444 |
| Full Name | Karl Theodore Wickstrom |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 790 Gail Gardner Way, Prescott, Arizona |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669476123 | NPI | - | NPPES |
| 446866 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 21726 (Arizona) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Karl Theodore Wickstrom, MD 790 Gail Gardner Way, Prescott, AZ 86305-2337 Ph: (928) 776-9900 | Karl Theodore Wickstrom, MD 790 Gail Gardner Way, Prescott, AZ 86305-2337 Ph: (928) 776-9900 |
Timothy D Olthoff, DO Radiology Medicare: Accepting Medicare Assignments Practice Location: 810 Whipple St, Prescott, AZ 86301 Phone: 928-771-7577 Fax: 928-458-2080 | |
Dr. Bernard Sakowicz, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 500 N Hwy 89, Northern Arizona Va Hcs, Prescott, AZ 86313 Phone: 928-445-4860 | |
Patrick K Hitchcock, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 500 N Us Highway 89, Prescott, AZ 86313 Phone: 928-776-6004 | |
Dr. Mary M Poncel, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 500 N Hwy 89, Northern Arizona Va Hcs, Prescott, AZ 86313 Phone: 928-445-4860 | |
Dr. Mohamed A Kirdani, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 980 Willow Creek Rd, Prescott, AZ 86301 Phone: 928-443-0077 Fax: 928-443-0019 | |
Michael J D'angelo, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1000 Ainsworth Dr, Suite 115, Prescott, AZ 86305 Phone: 928-778-1971 Fax: 928-443-8473 |