Provider Demographics
NPI:1366406480
Name:DAY, JOHN WICKLIFFE (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WICKLIFFE
Last Name:DAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:101 FEU FOLLET RD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-4234
Mailing Address - Country:US
Mailing Address - Phone:713-686-9194
Mailing Address - Fax:713-686-9413
Practice Address - Street 1:4131 SPICEWOOD SPRINGS RD STE J1
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8600
Practice Address - Country:US
Practice Address - Phone:713-686-9194
Practice Address - Fax:713-686-9413
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2022-10-27
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Provider Licenses
StateLicense IDTaxonomies
TXH1947207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine