| Doctor Name: | AARON B WICKLEY |
| NPI Number: | 1568625275 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | |
| Business Practice Address: | 3551 Roger Brooke Dr Fort Sam Houston, TX - 782344504 |
| Business Phone Number: | 2109163290 |
| Business Fax Number: | |
| Mailing Address: | 3551 Roger Brooke Dr, FORT SAM HOUSTON |
| State: | TX |
| Postal Code: | 782344504 |
| Phone Number: | 2109163290 |
| Fax Number: | |
| NPI Enumeration Date: | 07/03/2008 |
| NPI Last Update Date: | 08/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |