Provider Demographics
NPI:1962171637
Name:SIKORA, WYATT GRAHAM (PA-C)
Entity type:Individual
Prefix:
First Name:WYATT
Middle Name:GRAHAM
Last Name:SIKORA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W MINERAL AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-4507
Mailing Address - Country:US
Mailing Address - Phone:720-593-8896
Mailing Address - Fax:
Practice Address - Street 1:10103 RIDGEGATE PKWY STE G23
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-5524
Practice Address - Country:US
Practice Address - Phone:303-225-0025
Practice Address - Fax:303-225-0029
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant