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

Kelly Wickstrom, DO

Individual provider Internal Medicine Physician · NPI 1083092589

Kelly Wickstrom, DO is a Pulmonary Disease in Tucson, Arizona. Graduated from Des Moines University of Osteopathic Medicine and Health Sciences in 2015, 11 years ago. Practices with Tmc Medical Network, a 277-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
11
Trained at
Des Moines University of Osteopathic Medicine and Health Sciences
Licensed in
AZ
In the registry since
2015
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

5301 E Grant Rd
Tucson, AZ 85712-2805
Phone: (520) 324-5696
Fax: (520) 324-1583
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Critical Care Medicine (Internal Medicine) Physician (primary) Taxonomy 207RC0200X · Licence 008816 (AZ)
Internal Medicine Physician Taxonomy 207R00000X · Licence 008816 (AZ)
Internal Medicine Physician Taxonomy 207R00000X · Licence R2504 (AZ)
Pulmonary Disease Physician Taxonomy 207RP1001X · Licence 008816 (AZ)

Record details

NPI number1083092589
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 15, 2015
Last updated in NPPESApril 29, 2023
Certification dateFebruary 10, 2023

Medicare enrollment

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

Medicare specialtyPULMONARY DISEASE
Also practisesINTERNAL MEDICINE
Medical schoolDES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
Graduated 2015 (11 years in practice)
Group practice Tmc Medical Network — 277 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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