Karl Theodore Wickstrom, M.D.
Diagnostic Radiology Physician · Prescott, AZ
Karl Theodore Wickstrom, M.D. is a diagnostic radiology physician with a practice address in Prescott, Arizona, and NPI 1669476123, issued on Jun 10, 2005. Check the license (Arizona 21726, as entered in NPPES) on the Arizona Medical Board; the federal record below is the public data PlainDoctor holds for this provider.
- Name
- Karl Theodore Wickstrom
- Credential
- M.D.
- Primary taxonomy
- Diagnostic Radiology Physician 2085R0202X
- License number
- 21726 AZ
Self-reported in NPPES; status is on the state search - Practice location
- 790 Gail Gardner Way, Prescott, AZ 86305
- Phone
- (928) 776-9900
- Enumerated
- Jun 10, 2005
- Record last updated
- Feb 28, 2013 (not updated in 13 years: call before relying on the address or phone)
- Fax
- (928) 776-1444
- Medicaid ID
- 446866 AZ
- Entity
- Type 1 · individual
8 nearest diagnostic radiology physician records → All 869 in Arizona → Look up another NPI →
Verify Karl Theodore Wickstrom in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersArizona Medical Board
Search for license 21726Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Karl Theodore Wickstrom among 869 diagnostic radiology physician records in Arizona
Karl Theodore Wickstrom, M.D. is one of 869 diagnostic radiology physician records with a practice address in Arizona. 72% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does not. Its NPI, issued in 2005, is newer than 0% of them.
- NPI issued2005 · 0% of these records are older, 84% newer
- In a Medicare fileNo · 72% of these records are
- In the CMS Doctors and Clinicians fileNo · 66% of these records are
- Record last updated2013 · 56% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 2085R0202X and a Arizona practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
Diagnostic Radiology Physician providers in Arizona
There are 869 diagnostic radiology physician records in Arizona. No Medicare prescribing, quality score, industry payment or hospital affiliation is published for this NPI.
All 869 in Arizona → Every provider in Prescott → Diagnostic Radiology Physician nationwide →
The 8 diagnostic radiology physician records with the nearest ZIP codes
- David Lloyd, MDPrescott, AZ 863051932171618
- Ben Paxton, M.D.Prescott, AZ 863051548469372
- Ayad Agha, D.O.Prescott, AZ 863011730113903
- Sierra-Amber MabryPrescott, AZ 863011982388740
- Timothy Olthoff, DOPrescott, AZ 863011225019425
- Patrick Hitchcock, MDPrescott, AZ 863131477533776
- Mary Poncel, M.D.Prescott, AZ 863131609960707
- Bernard Sakowicz, M.D.Prescott, AZ 863131235236589
Common questions
What is Karl Theodore Wickstrom, M.D.'s NPI number?
Karl Theodore Wickstrom, M.D.'s National Provider Identifier (NPI) is 1669476123, issued on Jun 10, 2005. An NPI identifies a provider in billing; it is not a license.
Where is Karl Theodore Wickstrom, M.D. located?
The NPPES record lists a practice address at 790 Gail Gardner Way, Prescott, AZ, 86305. Phone: (928) 776-9900. Providers update this record themselves, so call before visiting.
How can I verify Karl Theodore Wickstrom, M.D.'s license?
NPPES lists Arizona license number 21726, as entered by the provider. Search the Arizona Medical Board at https://www.azmd.gov/. The NPPES record confirms identity only; the state search shows license status, expiration and public orders.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.