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General NPI Number Information
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NPI Number | 1265584817
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Entity Type | Individual
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Provider Name | THOMAS KENT STICKLEY DPM
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Gender | Male
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 02/19/2015
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Provider Practice Location Address
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Address Line | 25 TURNER LN
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City | WEST CHESTER
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State | PA
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Zip | 19380-4805
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Country | US
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Telephone | 610-696-1789
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Fax | 610-429-4258
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Provider Business Mailing Address
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Address Line | 25 TURNER LN
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City | WEST CHESTER
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State | PA
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Zip | 19380-4805
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Country | US
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Telephone | 610-696-1789
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Fax | 610-429-4258
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | SC003157L
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License Number State | PA
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