| Doctor Name: | DWIGHT RAYMOND STICKNEY |
| NPI Number: | 1225296676 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | C37059 |
| Business Practice Address: | 5275 Ashby Ln Granite Bay, CA - 957469425 |
| Business Phone Number: | 9166005116 |
| Business Fax Number: | 9167971583 |
| Mailing Address: | 5275 Ashby Ln, GRANITE BAY |
| State: | CA |
| Postal Code: | 957469425 |
| Phone Number: | 9166005116 |
| Fax Number: | 9167971583 |
| NPI Enumeration Date: | 06/01/2008 |
| NPI Last Update Date: | 06/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0203X |
| License Number: | C37059 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Therapeutic Radiology |
| Taxonomy Definition: | |