Provider Demographics
NPI:1992797633
Name:WIKNER, NORMAN E (MD)
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:E
Last Name:WIKNER
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 1:150 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1031
Mailing Address - Country:US
Mailing Address - Phone:303-316-2696
Mailing Address - Fax:
Practice Address - Street 1:150 S CHERRY ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1031
Practice Address - Country:US
Practice Address - Phone:303-316-2696
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO25968207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO199038Medicare ID - Type Unspecified
CO01259688Medicaid
CO070013418OtherRAILROAD MEDICARE
E41892Medicare UPIN