Wickey, Loella E. Clark

Wickey, Loella E. Clark is an individual health care provider with primary practice located at 130 Center Way , Corning NY 14830-2255. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wickey, Loella E. Clark can be contacted via phone (607) 936-9971.

Contact Information

Primary practice address
130 Center Way Corning NY 14830-2255
Phone: (607) 936-9971
Fax: (607) 936-2600
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 173504-1 New York

Profile Details

NPI number 1235105230
LBN Legal business name Wickey, Loella E. Clark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Nov 2nd, 2007 - about 17 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1235105230 NPPES
New York MEDICAID 01060824
New York MEDICAID 0011150680003
New York Other CC8362

Popular Providers