NPI 1972578672

Gregory Mathew Wickern, MD

Practitioner Allergy Physician Twin Falls, ID

Practice location

Address: 1502 Locust St N STE 600, Twin Falls, ID 83301-4164
Phone: (208) 734-6091
Fax: (208) 734-4654
Mailing address: 800 Falls Ave Suite #2, Twin Falls, ID 83301-3366

Registered specialties (3)

Allergy Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207KA0200X Licence M-10495 (ID)

Other Allergy & Immunology providers in Idaho →

Allergy & Immunology Physician

Allopathic & Osteopathic Physicians Taxonomy 207K00000X Licence 13018 (NV)

Allergy & Immunology Physician

Allopathic & Osteopathic Physicians Taxonomy 207K00000X Licence 6578473-1205 (UT)

Registry record

NPI: 1972578672
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Feb 2006
Record last updated: 17 Nov 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.