National Provider Identifier
Loella E. Clark Wickey, MD
Loella E. Clark Wickey, MD is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Corning, NY and a listed phone number of (607) 936-9971.
Profile Overview
- NPI
- 1235105230
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- February 28, 2006
- Last Updated
- November 02, 2007
Practice Location
- 130 Center Way
- Corning, NY 14830-2255
Phone: (607) 936-9971
Mailing Address
- 1 Guthrie Sq
- Sayre, PA 18840-1625
Specialties
- Family Medicine Physician (207Q00000X)
Full Record
- NPI
- 1235105230
- Entity Type
- Individual
- Last Name
- Wickey
- First Name
- Loella
- Middle Name
- E. Clark
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 1 Guthrie Sq
- Mailing City
- Sayre
- Mailing State
- PA
- Mailing ZIP Code
- 18840-1625
- Mailing Country
- US
- Mailing Phone
- (570) 888-5858
- Mailing Fax
- (570) 882-3007
- Practice Street Address
- 130 Center Way
- Practice City
- Corning
- Practice State
- NY
- Practice ZIP Code
- 14830-2255
- Practice Country
- US
- Practice Phone
- (607) 936-9971
- Practice Fax
- (607) 936-2600
- Enumeration Date
- February 28, 2006
- Last Updated
- November 02, 2007
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X)
- Other Identifiers
- 01060824 (NY), 0011150680003 (PA), CC8362 (NY, Rr Medicare Group)