MR. TAL D WICK (NPI# 1326376328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326376328 |
| Entity Type | Individual |
| Full Name | MR. TAL D WICK |
| Credential | EMT-B |
| Practice Address |
Lyster Army Health Clinic Bldg 301, Andrews Ave Fort Rucker AL 36362-5333 |
| Practice Telephone | 3342557754 |
| Mailing Telephone | 3342557754 |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 146N00000X | Emergency Medical Technician, Basic | B1719026 | AL | Emergency Medical Service Providers |
| Y | 246Z00000X | Specialist/Technologist, Other | Technologists, Technicians & Other Technical Service Providers |
| Street Address |
LYSTER ARMY HEALTH CLINIC BLDG 301, ANDREWS AVE |
| City | FORT RUCKER |
| State | AL |
| Zip Code | 36362-5333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912964115 | Wendy Ruth Campbell | Nurse Practitioner | Lyster Army Health Clinic, 301 Andrews Avenue, Fort Rucker, AL 36362 | 2006-05-01 |
| 1598311409 | Catherine Rebecca Baden | Technician | Lyster Army Health Clinic, Bldg 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-08-15 |
| 1447802392 | Ginger Lynn Tanner | Registered Nurse | Lyster Army Health Clinic, Building 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-07-11 |
| 1659923506 | Joni E Prugh | Physical Therapy Assistant | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-07-11 |
| 1063074805 | Crystal Harris | Emergency Medical Technician, Basic | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-07-02 |
| 1871158444 | Dorma Sanders | Registered Nurse | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-05-08 |
| 1942769047 | Emily Sue Canlas | Registered Nurse | Lyster Army Health Clinic, Bldg. 301 Andrews Ave., Fort Rucker, AL 36362-5333 | 2019-03-18 |
| 1366900821 | Michael Joseph Brown | Emergency Medical Technician, Basic | Lyster Army Health Clinic, Building 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-03-04 |
| 1861956823 | Katherine Lambeth | Technician/Technologist | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-01-24 |
| 1376014480 | Patrick Gabriel Lawson | Emergency Medical Technician, Paramedic | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2018-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
| 1417589268 | Jacob Michael Lezon | Emergency Medical Technician, Basic | 30501 Nevins St., Ft. Rucker, AL 36362 | 2020-02-10 |
| 1225535388 | Rhonda Lewis Wesolek | Dental Hygienist | Bldg 4405, Innkeeper Street, Fort Rucker, AL 36362 | 2018-04-06 |
| 1770013369 | National Vision, Inc. | Technician/Technologist | Bldg 9214, Fort Rucker, AL 36362 | 2017-06-15 |
| 1750730958 | Teresa Morgan Knighten | Dental Hygienist | 4405 Innkeepers St, Fort Rucker, AL 36362 | 2016-06-08 |
| 1568826246 | David Virgil II | Technician, Other | 2218 6th Avenue Building 4102, Fort Rucker, AL 36362 | 2016-04-08 |
| 1356771257 | Robert E Smith | Emergency Medical Technician, Intermediate | Blding 301 Andrew Ave, Ft Rucker, AL 36362 | 2013-11-14 |
| 1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
| 1689913808 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Fort Rucker Bldg. 9214, Daleville, AL 36362 | 2013-02-07 |
| 1275880205 | Sandra Lynn Griffin Banner | Optometrist | 33 Endl Ave, Fort Rucker, AL 36362 | 2012-08-09 |
| Find all providers in zip 36362 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710399464 | Sharon Velez Erickson | Specialist/Technologist, Other | 64 Red Cloud Rd, Fort Rucker, AL 36362-2324 | 2014-05-29 |
| 1336371533 | Antonio Contes | Specialist/Technologist, Other | Bldg. 301, Andrews Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2009-08-20 |
| 1639347008 | Terrence Arashi Elliott | Specialist/Technologist, Other | Andrews Ave, Bldg 301, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2008-02-19 |
| 1891963260 | Harvey Gayloyd Landy Sr. | Specialist/Technologist, Other | Bldg 301, Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2008-02-19 |
| 1386812964 | Judith Annette Barnes | Specialist/Technologist, Other | Bldg 301 Andrews Ave., Fort Rucker, AL 36362 | 2008-02-15 |
| 1235772955 | Soreeya Sythong | Specialist/Technologist, Other | 301 Andrews Ave, Fort Rucker, AL 36362 | 2019-10-25 |
| 1104291368 | Marlon Thomas | Specialist/Technologist, Other | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2015-12-14 |
| 1780053660 | Victor Heard | Specialist/Technologist, Other | Bldg. 301 Andrews Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2015-09-21 |
| 1831596543 | Hilda Hernandez | Specialist/Technologist, Other | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2014-11-24 |
| 1366843559 | Nichols Poitra | Specialist/Technologist, Other | Bldg 301 Andrews Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2014-09-08 |
| Find all providers in FORT RUCKER | ||||
| City | FORT RUCKER |
| Zip Code | 36362 |
Please comment or provide details below to improve the information on MR. TAL D WICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.