John David Wise in Green Bay - Physician Assistant
John David Wise - NPI 1093739724
John David Wise is a Physician Assistant in Green Bay, Wisconsin. John David Wise practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for John David Wise is 1093739724. The last update date is 2021-11-24.
John David Wise's current location address is Po Box 19070, Green Bay, Wisconsin. You can contact this provider via phone number 9204964700 and fax number 9204964705. The mailing address for John David Wise is Po Box 19070, Green Bay, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | John David Wise |
|---|---|
| Address | Po Box 19070, Green Bay, Wisconsin |
| Phone Number | 9204964700 |
| Fax Number | 9204964705 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1093739724 |
|---|---|
| Provider Enumeration Date | 2006-07-26 |
| Last Updated Date | 2021-11-24 |
Provider Mailing Address Detail
| Address | Po Box 19070 |
|---|---|
| City | Green Bay |
| State | Wisconsin (WI) |
| Post Code | 543079070 |
| Phone Number | 9204964700 |
| Fax Number | 9204964705 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 941 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 42989000 | WI | -- |
Post Comment/ Review Below
What is the unique identifier code issued to John David Wise by the Centers for Medicare & Medicaid Services (CMS)?
The John David Wise has been assigned the NPI (National Provider Identifier) 1093739724. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the John David Wise located?
The John David Wise is located at Po Box 19070, Green Bay, WI 543079070.
What is the John David Wise's specialty and taxonomy code?
The John David Wise's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
On what date did John David Wise receive its 1093739724 assignment from the Centers for Medicare & Medicaid Services?
The John David Wise was assigned its 1093739724 on 2006-07-26, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the John David Wise's information last updated?
The John David Wise's information was last updated on 2021-11-24.
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