Wickboldt, Alvah Tyson

Wickboldt, Alvah Tyson is an individual health care provider with primary practice located at 1514 Jefferson Hwy Brent House Room 634, New Orleans LA 70121-2429. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Wickboldt, Alvah Tyson can be contacted via phone (504) 842-3000.

Contact Information

Primary practice address
1514 Jefferson Hwy Brent House Room 634 New Orleans LA 70121-2429
Phone: (504) 842-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 305062 Louisiana

Profile Details

NPI number 1083971006
LBN Legal business name Wickboldt, Alvah Tyson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2012
Last updated Jul 21st, 2022 - 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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