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DR. WICKIZER
NPI 1710408117
Clinic/Center - Multi-Specialty in Midlothian, VA

Active since July 06, 2017
2802 OTTERDALE RD, MIDLOTHIAN, VA 23112(804) 938-0264 Get Directions Write a Review

NPPES record last updated: July 6, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Wickizer NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. WICKIZER (NPI 1710408117) is a healthcare organization registered as a multi-specialty in Midlothian, Virginia and active in the NPI registry since July 2017. The organization lists Boyd R Wickizer, President, as its authorized official.

NPPES Registry Identity

NPI1710408117
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameBOYD R WICKIZER MD LLC
Location Address2802 OTTERDALE RDMidlothian, VA 23112-5408
Mailing AddressPo Box 446Midlothian, VA 23113-0446 · (804) 938-0264
Phone(804) 938-0264
Organization SubpartNo
Authorized OfficialBoyd R WickizerPresident · (804) 938-0264
Enumeration DateJuly 6, 2017
✔ NPI 1710408117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
License✔ Licensed in VA · 0101047692
2802 OTTERDALE RD, Midlothian, VA 23112
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Other Names 1

Doing Business AsDr. Wickizer

Other Identifiers 1

Medicaid1750330353VA

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Boyd R Wickizer MD LLC's NPI number?

The NPI number for Boyd R Wickizer MD LLC is 1710408117. It was assigned to this organization in the NPPES registry on July 6, 2017. The provider is doing business as Dr. Wickizer.

Where is Boyd R Wickizer MD LLC located?

Boyd R Wickizer MD LLC is located at 2802 Otterdale Rd, Midlothian, VA 23112. The listed phone number is (804) 938-0264.

What is Boyd R Wickizer MD LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

When was this NPI record last updated?

The NPPES record for Boyd R Wickizer MD LLC was last updated on July 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.