Wickham, Jesse M
Wickham, Jesse M is an sole proprietor health care provider with primary practice located at 3551 Roger Brooke Dr , Jbsa Ft Sam Houston TX 78234-4504. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Wickham, Jesse M can be contacted via phone (210) 916-7408.Contact Information
Primary practice address
3551 Roger Brooke Dr
Jbsa Ft Sam Houston TX 78234-4504
Phone: (210) 916-7408
Fax: (210) 916-3585
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 02003331A | Indiana |
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 23573 | Mississippi |
Profile Details
| NPI number | 1376602060 |
|---|---|
| LBN Legal business name | Wickham, Jesse M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 8th, 2006 |
| Last updated | Mar 17th, 2018 - about 6 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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