Karl Theodore Wickstrom, M.D.

NPI #1669476123 in Prescott, Arizona

Provider Information

NPI Number
1669476123
Entity Type
Individual
Name
Karl Theodore Wickstrom, M.D.
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Radiology - Diagnostic Radiology
Credential
M.D.
Enumeration Date
Jun 10, 2005
Last Updated
Feb 28, 2013

Practice Location

Address
790 GAIL GARDNER WAY
State
Arizona
ZIP Code
86305-2337
Phone
(928) 776-9900

Specialties & Taxonomy Codes

Specialty
Radiology - Diagnostic RadiologyDiagnostic Radiology

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