Basic Information
| Provider Information | |||||||||
| NPI: | 1356954572 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WYKES | ||||||||
| FirstName: | AMELIA | ||||||||
| MiddleName: | SUE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13088 TOWNSHIP ROAD 150 | ||||||||
| Address2: | |||||||||
| City: | ARLINGTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458149768 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4196196438 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1900 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | FINDLAY | ||||||||
| State: | OH | ||||||||
| PostalCode: | 458401214 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4194234500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/27/2020 | ||||||||
| LastUpdateDate: | 08/27/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 50.006587 | OH | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 50.006587RX | OH | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.