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General NPI Number Information
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NPI Number | 1932381886
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Entity Type | Organization
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Legal Business Name | FRANCIS J. WAICKMAN, M.D. & ASSOCIATES, INC.
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Dates
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Enumeration Date | 12/03/2007
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 3090 W MARKET ST STE 110
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City | FAIRLAWN
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State | OH
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Zip | 44333-3615
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Country | US
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Telephone | 330-867-3767
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Fax | 330-867-4857
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Provider Business Mailing Address
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Address Line | 3090 W MARKET ST STE 110
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City | FAIRLAWN
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State | OH
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Zip | 44333-3615
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Country | US
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Telephone | 330-867-3767
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Fax | 330-867-4857
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Authorized Official
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Title or Position | PRACTICE OWNER
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Name | DR. MICHAEL JOHN WAICKMAN
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Credential | M.D.
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Telephone | 330-867-3767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35-05-9856-W
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License Number State | OH
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