Wickard, Paul W
Wickard, Paul W is an individual health care provider with primary practice located at 1061 Harmon Ave Ste 1D03 , Fort Stewart GA 31314-5641. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Wickard, Paul W can be contacted via phone (912) 435-7013.Contact Information
Primary practice address
1061 Harmon Ave Ste 1D03
Fort Stewart GA 31314-5641
Phone: (912) 435-7013
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 002062 | Georgia |
Profile Details
| NPI number | 1306898648 |
|---|---|
| LBN Legal business name | Wickard, Paul W |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2006 |
| Last updated | Oct 7th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306898648 | NPPES |
| Georgia | MEDICAID | 97WCGNF |
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