Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Otto William Wickstrom III, MD

Individual provider Orthopaedic Surgery Physician · NPI 1487826939

Dr. Otto William Wickstrom III, MD is a Hand Surgery in Bloomington, Indiana. Qualified in 2003, 23 years ago. Practices with Iu Health Medical Group, LLC, a 4,351-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana and Washington.

Years since qualifying
23
Licensed in
IN, WA
In the registry since
2008
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

583 S Clarizz Blvd
Bloomington, IN 47401-5515
Phone: (812) 333-2663
Fax: (812) 349-9206
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 16528 E Desmet Ct, Spokane Valley, WA 99216-3522 — (509) 944-8920

Specialties & licences

Orthopaedic Hand Surgery Physician (primary) Taxonomy 207XS0106X · Licence MD61074238 (WA)
Orthopaedic Surgery Physician Taxonomy 207X00000X · Licence MD61074238 (WA)
Specialist Taxonomy 174400000X · Licence 01065381A (IN)

Record details

NPI number1487826939
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 25, 2008
Last updated in NPPESApril 29, 2021
Certification dateApril 29, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyHAND SURGERY
Also practisesORTHOPEDIC SURGERY
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Iu Health Medical Group, Llc — 4351 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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