Individual provider · Type 1 NPI

Karl Theodore Wickstrom, MD

Diagnostic Radiology Physician · Prescott, AZ

NPI number 1669476123 Active

Practice location

790 Gail Gardner Way
Prescott, AZ 86305-2337

Call (928) 776-9900 Map

Fax (928) 776-1444

Specialties and licenses

TaxonomyCodeLicense
Diagnostic Radiology Physician Primary 2085R0202X21726 (AZ)

Diagnostic Radiology Physician: A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

2 other providers at this address

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About NPI 1669476123

Karl Theodore Wickstrom, MD's National Provider Identifier is 1669476123, issued on Jun 10, 2005. The primary taxonomy on file is Diagnostic Radiology Physician (2085R0202X), and the practice location is in Prescott, AZ. The record was last updated on Feb 28, 2013.