Individual provider · Type 1 NPI

Kyle Gary Fitzgerald Wicker Jr., MD

Student in an Organized Health Care Education/Training Program · Philadelphia, PA

NPI number 1912757360 Active

Practice location

3400 Spruce St
Philadelphia, PA 19104-4238

Call (404) 396-3851 Map

Mailing address

7466 Silver Arrow Trl
Austell, GA 30168-2401

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1912757360

Kyle Gary Fitzgerald Wicker Jr., MD's National Provider Identifier is 1912757360, issued on Mar 26, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Philadelphia, PA. The record was last updated on Mar 26, 2024.