Wicker, Brian Kyle

Wicker, Brian Kyle is an individual health care provider with primary practice located at 2205 Jefferson Davis Dr , Oxford MS 38655-5221. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Wicker, Brian Kyle can be contacted via phone (662) 238-2800.

Contact Information

Primary practice address
2205 Jefferson Davis Dr Oxford MS 38655-5221
Phone: (662) 238-2800
Fax: (662) 238-2808
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X PT2995 Mississippi

Profile Details

NPI number 1437185188
LBN Legal business name Wicker, Brian Kyle
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2006
Last updated Jan 27th, 2011 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437185188 NPPES
Mississippi MEDICAID 001245531

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