Provider Demographics
NPI:1962698654
Name:HURST-WICKER, KARL SETH (MD)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:SETH
Last Name:HURST-WICKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 S HIGLEY RD STE 103
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1167
Mailing Address - Country:US
Mailing Address - Phone:602-633-4334
Mailing Address - Fax:888-815-1389
Practice Address - Street 1:5590 W CHANDLER BLVD STE 3
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85226-3744
Practice Address - Country:US
Practice Address - Phone:602-633-4334
Practice Address - Fax:888-815-1389
Is Sole Proprietor?:No
Enumeration Date:2007-09-17
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI53982207L00000X, 208VP0014X
UT6351856-1205207L00000X
AZ42472208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology