MEDICARE: DANIEL J WICKERT M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	01034216A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982698783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL J WICKERT M.D.

Provider Business Mailing Address
First Line	:	3920 ST FRANCIS WAY
Second Line	:	SUITE 110
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-4917
Country	:	US
Telephone Number	:	765-428-5800
Fax Number	:	765-428-5802

Provider Business Practice Location Address
First Line	:	3920 ST FRANCIS WAY
Second Line	:	SUITE 110
City	:	LAFAYETTE
State	:	IN
Zip	:	47905-4917
Country	:	US
Telephone Number	:	765-428-5800
Fax Number	:	765-428-5802

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	10/04/2011

Similar Medicare Providers

1497520621 — BRITTANY LYNN LEPARD WHNP
Practice Location Address:

3920 ST FRANCIS WAY STE 100
LAFAYETTE, IN
47905-4917

Practice Phone: 765-428-5990
Practice Fax: 765-428-5896

1417942483 — SUSAN MARIE SCHNERRE M.D.
Practice Location Address:

3920 ST FRANCIS WAY STE 100
LAFAYETTE, IN
47905-4917

Practice Phone: 765-428-5888
Practice Fax: 765-428-5897

1851386486 — JOHN MICHAEL BROWN M.D.
Practice Location Address:

3920 ST FRANCIS WAY , SUITE 100
LAFAYETTE, IN
47905-4917

Practice Phone: 765-428-5888
Practice Fax: 765-428-5897

1326017955 — RENEE J KNUTSON MD
Practice Location Address:

3920 ST FRANCIS WAY STE 110
LAFAYETTE, IN
47905-4917

Practice Phone: 765-428-5990
Practice Fax: 765-428-5896

1518936079 — JOSEPH RAYMOND SHINN MD
Practice Location Address:

3920 ST FRANCIS WAY STE 100
LAFAYETTE, IN
47905-4917

Practice Phone: 765-428-5888
Practice Fax: 765-428-5897

1366401184 — SCOTT LAWRENCE SINNOTT MD
Practice Location Address:

3920 ST FRANCIS WAY
LAFAYETTE, IN
47905-4917

Practice Phone: 765-428-5990
Practice Fax: 765-428-5896

Directions to “ DANIEL J WICKERT M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.