Mark Edwin Wisner in Leavenworth - Medical
Mark Edwin Wisner - NPI 1598771586
Mark Edwin Wisner is a Medical in Leavenworth, Kansas. Mark Edwin Wisner practices all healthcare services and medical treatments related to Medical. The NPI Number for Mark Edwin Wisner is 1598771586. The last update date is 2010-09-23.
Mark Edwin Wisner's current location address is 4101 S 4th St, Leavenworth, Kansas. You can contact this provider via phone number 9137585416 and fax number 9137584219. The mailing address for Mark Edwin Wisner is 4101 S 4th St, Leavenworth, Kansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Mark Edwin Wisner |
|---|---|
| Address | 4101 S 4th St, Leavenworth, Kansas |
| Phone Number | 9137585416 |
| Fax Number | 9137584219 |
| Sole Proprietor | N |
| Credentials | PH.D., PA- |
NPI Number Detail
| NPI Number | 1598771586 |
|---|---|
| Provider Enumeration Date | 2006-07-31 |
| Last Updated Date | 2010-09-23 |
Provider Mailing Address Detail
| Address | 4101 S 4th St |
|---|---|
| City | Leavenworth |
| State | Kansas (KS) |
| Post Code | 660485014 |
| Phone Number | 9137585416 |
| Fax Number | 9137584219 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA 15-000385 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100340730A | KS | -- | |
| 426715 | KS | BLUE CROSS/BLUE SHIELD |
Post Comment/ Review Below
What is the unique identifier code issued to Mark Edwin Wisner by the Centers for Medicare & Medicaid Services (CMS)?
The Mark Edwin Wisner has been assigned the NPI (National Provider Identifier) 1598771586. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete street address where Mark Edwin Wisner is physically located?
The Mark Edwin Wisner is physically situated at the following address: 4101 S 4Th St, Leavenworth, KS, 660485014.
What is Mark Edwin Wisner's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Mark Edwin Wisner's specialized field of practice is Medical, and the corresponding taxonomy code that categorizes this area of specialization is 363Am0700X.
When did Mark Edwin Wisner receive its 1598771586 assignment?
The Mark Edwin Wisner was assigned its 1598771586 on 2006-07-31, which is the date when this unique identifier was issued to the organization.
As of what date was the information regarding Mark Edwin Wisner, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Mark Edwin Wisner, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2010-09-23.