Wickern, Gregory Mathew

Wickern, Gregory Mathew is an individual health care provider with primary practice located at 1502 Locust St N Ste 600 , Twin Falls ID 83301-4164. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Allergy & Immunology, Allopathic & Osteopathic Physicians / Allergy. Allopathic & Osteopathic Physicians / Allergy is his primary health care specialty. Wickern, Gregory Mathew can be contacted via phone (208) 734-6091.

Contact Information

Primary practice address
1502 Locust St N Ste 600 Twin Falls ID 83301-4164
Phone: (208) 734-6091
Fax: (208) 734-4654
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 13018 Nevada
Allopathic & Osteopathic Physicians / Allergy & Immunology 207K00000X 6578473-1205 Utah
Allopathic & Osteopathic Physicians / Allergy 207KA0200X M-10495 Idaho

Profile Details

NPI number 1972578672
LBN Legal business name Wickern, Gregory Mathew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Nov 17th, 2020 - about 4 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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