Wickard, Paul W

Wickard, Paul W is an individual health care provider with primary practice located at 1061 Harmon Ave Ste 1D03 , Fort Stewart GA 31314-5641. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Wickard, Paul W can be contacted via phone (912) 435-7013.

Contact Information

Primary practice address
1061 Harmon Ave Ste 1D03 Fort Stewart GA 31314-5641
Phone: (912) 435-7013
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 002062 Georgia

Profile Details

NPI number 1306898648
LBN Legal business name Wickard, Paul W
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Oct 7th, 2010 - about 16 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 1306898648 NPPES
Georgia MEDICAID 97WCGNF

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