NPIMap

Organization Active NPI

Paul T. Wicklund, M.D., P.a.

  • Orthopaedic Surgery Physician
  • Edina, MN
National Provider Identifier
1407155054
Registry record updated Mar 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
19937 Issued in MN
Legal business name
PAUL T. WICKLUND, M.D., P.A.
Practice address
6545 France Ave S Ste 363
Edina, MN 55435-2121
Phone
(952) 405-8724
Fax
(952) 933-6516
NPI assigned
Mar 22, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2011

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

Authorized official

Name
Paul T Wicklund, MD
Title
Owner
Phone
(651) 238-3376

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 19937 MN Primary

Addresses

Primary practice location

6545 France Ave S Ste 363
Edina, MN 55435-2121

Mailing address

6545 France Ave S Ste 363
Edina, MN 55435-2121
Phone (952) 405-8724

National Provider Directory

National Provider Directory

Locations

6545 France Ave S
Ste 363
Edina, MN 55435
Phone (952) 405-8724

1021 Bandana Blvd E
Saint Paul, MN 55108
Phone (651) 241-3939

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1300752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300752000000",
    "number": "1407155054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S STE 363",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352121",
            "telephone_number": "952-405-8724",
            "fax_number": "952-933-6516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6545 FRANCE AVE S STE 363",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352121",
            "telephone_number": "952-405-8724",
            "fax_number": "952-933-6516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL T. WICKLUND, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-22",
        "last_updated": "2011-03-22",
        "status": "A",
        "authorized_official_last_name": "WICKLUND",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-238-3376",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MN",
            "license": "19937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2011; 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.