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Karl Theodore Wickstrom, M.D.

Diagnostic Radiology Physician in Prescott, AZ · enumerated 2005.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1669476123

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Registry record

Entity type Individual (Type 1)
Name Karl Theodore Wickstrom
Credential M.D.
Sex Male
Practice address 790 Gail Gardner Way, Prescott, AZ, 86305
Phone (928) 776-9900
Fax (928) 776-1444
Enumeration date Jun 10, 2005
Last updated in NPPES Feb 28, 2013

Taxonomy & licenses

2085R0202X Diagnostic Radiology Physician Allopathic & Osteopathic Physicians · License 21726 (AZ) Primary
MD · Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential

Other identifiers

Identifier Type State Issuer
446866 Medicaid AZ -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

Where does Karl Wickstrom practice?
The practice location on file with NPPES is in Prescott, AZ. Providers can have multiple locations; NPPES lists the primary practice address.
What is the NPI number for Karl Wickstrom?
The National Provider Identifier (NPI) for Karl Wickstrom is 1669476123, a Type 1 (individual) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-02-28.