Jonathan Eric Wickiser

MD | Pediatric Hematology-Oncology | Male

---

Complete Profile:

Jonathan Eric Wickiser basic information including his official name, gender, specialization, credentials etc. are as mentioned below.

Specialization :	Pediatrics Pediatric Hematology-Oncology
Provider Name :	Jonathan Eric Wickiser
Credential :	MD
Gender :	Male

Business Address:

Jonathan Eric Wickiser address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.

Primary Address :	5323 Harry Hines Blvd Dallas, TX, 75390-7201 United States
Phone Number :	214-730-5437

Professional Identification Codes:

NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.

NPI Number :	1194740688
NPI Entity Type :	Individual
First Enrolment Date :	13 Jul, 2006
Last Updated On :	24 Apr, 2012

Medicare Participation:

Jonathan Eric Wickiser participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.

Medicare PECOS ID :	2769488014
Medicare Enrollment ID :	I20061010000812
Primary Specialty :	Pediatric Medicine
Medical School :	Texas Tech University Health Science Center School Of Medicine
Graduation Year :	1999
Accepts Medicare?	Yes. Jonathan Eric Wickiser accepts medicare insurance.

Group Practice Association:

Jonathan Eric Wickiser is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which Jonathan Eric Wickiser is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.

Organisation Name :	Group Practice ID	No. of Members	Practice Address	Group Accepts Medicare
University Of Texas Southwestern Medical Center	0648188250	2495	5323 Harry Hines Blvd Dallas, TX - 753907208 Ph: 2166480600	Yes

Licenses and Specialities:

Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Jonathan Eric Wickiser are as mentioned. Primary taxonomy code for Jonathan Eric Wickiser, MD is 2080P0207X (Pediatrics Pediatric Hematology-Oncology).

Taxonomy Code	Speciality	Primary	License No.	State
208000000X	Pediatrics	No	M4653	TX
2080P0207X	Pediatrics Pediatric Hematology-Oncology	Yes	M4653	TX

Mailing Address:

Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.

Mailing Address :	Po Box 845347 Dallas, TX, 75284-5347 United States
Phone Number :	214-730-5437

Business Location:

Patients can refer following map for directions to Jonathan Eric Wickiser practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.