Provider Demographics
NPI:1790869154
Name:WIKLER, DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:WIKLER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8985 S PECOS RD
Mailing Address - Street 2:#4A
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7162
Mailing Address - Country:US
Mailing Address - Phone:702-433-1332
Mailing Address - Fax:702-547-4931
Practice Address - Street 1:8985 S PECOS RD
Practice Address - Street 2:#4A
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89074-7162
Practice Address - Country:US
Practice Address - Phone:702-433-1332
Practice Address - Fax:702-547-4931
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV640207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002019332Medicaid
NVD27358Medicare UPIN
NVWCHKY02Medicare ID - Type UnspecifiedMEDICARE