Wickersham, Elizabeth A
Wickersham, Elizabeth A is an sole proprietor health care provider with primary practice located at 4345 W Memorial Rd Suite 110, Oklahoma City OK 73134-1702. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine, Allopathic & Osteopathic Physicians / Pain Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Wickersham, Elizabeth A can be contacted via phone (405) 418-7000.Contact Information
Primary practice address
4345 W Memorial Rd Suite 110
Oklahoma City OK 73134-1702
Phone: (405) 418-7000
Fax: (405) 418-7099
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hospice and Palliative Medicine | 207QH0002X | 20273 | Oklahoma |
| Allopathic & Osteopathic Physicians / Pain Medicine | 208VP0000X | 20273 | Oklahoma |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 20273 | Oklahoma |
Profile Details
| NPI number | 1992706048 |
|---|---|
| LBN Legal business name | Wickersham, Elizabeth A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2005 |
| Last updated | Oct 25th, 2023 - about last year |
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 | 1992706048 | NPPES |
| Oklahoma | MEDICAID | 200036870A |
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