Otto W Wickstrom Jr. M.D. Inc.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

01018161A Issued in IN

Legal business name

OTTO W WICKSTROM JR. M.D. INC.

Practice address

2360 N National Rd
Columbus, IN 47201-3732

Phone

(812) 372-2437

Fax

(812) 379-2621

NPI assigned

Feb 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Otto W Wickstrom, M.D.

Title

Physician

Phone

(812) 372-2437

Specialties & licenses 1

Addresses

Other names 1

• Otto W Wickstrom Jr. M.D. Inc. Former legal business name

Locations

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447395330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2360 N NATIONAL RD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013732",
            "telephone_number": "812-372-2437",
            "fax_number": "812-379-2621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2360 N NATIONAL RD",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472013732",
            "telephone_number": "812-372-2437",
            "fax_number": "812-379-2621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTTO W WICKSTROM JR. M.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WICKSTROM",
        "authorized_official_first_name": "OTTO",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "812-372-2437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01018161A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Otto W Wickstrom Jr. M.D. Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Sylvester N Osayi, M.D.
• Anna Grace Osborn
• Michael Osenbach, RBT
• Ossip Optometry, P.C (VanArsdall Family Optometry)
• Otolaryngology Specialty Care, LLC
• Our Hospice of South Central Indiana, Inc.
• Ourhealth Physicians Group, LLC
• Lillian Owens, RBT
• Sarah Owens
• Paulette Padilla Shields, MD

• Orthopaedic Surgery Physician in Columbus, IN
• Providers in Columbus, IN by specialty
• Orthopaedic Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.