Search › Indiana › 207XS0106X
Otto Wickstrom, M.D
NPI 1487826939 · on the registry since 2008
Practice
- Address
- 583 S Clarizz Blvd
Bloomington, IN 47401 - Phone
- (812) 333-2663
- Fax
- (812) 349-9206
- Organisation at this address
- Orthopedics Of South Central Indiana Llc
Indiana University Health Southern Indiana Physicians, LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 25
Additional practice sites
- 16528 E Desmet Ct, Spokane Valley, WA
Registry record
- Primary taxonomy
- 207XS0106X
207XS0106X
- Also registered as
- 207X00000X
174400000X - Licence states on file
- WA, IN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-04-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana