David Wykstra, MD, PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

DAVID WYKSTRA, MD, PC

Practice address

2005 Pioneer St Ste C
Waycross, GA 31501-6205

Phone

(912) 490-4805

NPI assigned

Nov 15, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Wykstra, MD

Title

Ceo

Phone

(912) 286-9192

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646092800000",
    "number": "1154087013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3437 DRIGGERS RD",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315039512",
            "telephone_number": "912-286-9192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 PIONEER ST STE C",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016205",
            "telephone_number": "912-490-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID WYKSTRA, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-15",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A",
        "authorized_official_last_name": "WYKSTRA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-286-9192",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Waycross, GA
• Providers in Waycross, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.