Jason W. Wickersham, M.D.

NPI #1073594172 in Parkston, South Dakota

Provider Information

NPI Number
1073594172
Entity Type
Individual
Name
Jason W. Wickersham, M.D.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Family Medicine
Credential
M.D.
Enumeration Date
Nov 7, 2005
Last Updated
Aug 9, 2012

Practice Location

Address
401 W GLYNN DR
ZIP Code
57366-9605
Phone
(605) 928-3311

Specialties & Taxonomy Codes

Specialty
Family Medicine

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