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Dr. Thomas Anthony Licata, DO
Family Medicine Physician in Wausau, Wisconsin
NPI 1427638659

Thomas Anthony Licata is a Family Medicine Physician based in Wausau, WI. Thomas Anthony Licata practices in Wausau, WI and has the professional credentials of DO. The NPI Number for Thomas Anthony Licata is 1427638659 and holds a License No. (Wisconsin).

The current practice location address for Thomas Anthony Licata is 425 Wind Ridge Dr, Wausau, WI and can be reached out via phone at 715-675-3391.

Location: 425 Wind Ridge Dr, Wausau, WI, 54401-4149
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1427638659
Provider Name
Thomas Anthony Licata
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
425 Wind Ridge Dr, Wausau, WI, 54401-4149
Phone Number
715-675-3391
Fax Number
Provider Enumeration Date
04/12/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
425 Wind Ridge Dr
City
Wausau
State
Wisconsin
Zip
54401-4149
Phone Number
715-675-3391
Fax Number
person
Provider Business Mailing Address Details
Address
425 Wind Ridge Dr
City
Wausau
State
Wisconsin
Zip
54401-4149
Phone Number
715-675-3391
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
81059-21 (Wisconsin)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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