Individual provider · Type 1 NPI
Otto William Wickstrom Iii, MD
Orthopaedic Hand Surgery Physician · Bloomington, IN
NPI number
1487826939
Active
Practice location
583 S Clarizz Blvd
Bloomington, IN 47401-5515
Fax (812) 349-9206
Other practice locations
- 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 · (509) 944-8920
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD61074238 (WA) |
| Orthopaedic Hand Surgery Physician Primary | 207XS0106X | MD61074238 (WA) |
| Specialist | 174400000X | 01065381A (IN) |
Orthopaedic Hand Surgery Physician: An orthopaedic surgeon trained in the investigation, preservation and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist.
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Other orthopaedic hand surgery physician providers in Bloomington
About NPI 1487826939
Otto William Wickstrom Iii, MD's National Provider Identifier is 1487826939, issued on Mar 25, 2008. The primary taxonomy on file is Orthopaedic Hand Surgery Physician (207XS0106X), and the practice location is in Bloomington, IN. The record was last updated on Apr 29, 2021.