Wiesner, Philipp Alexander

Wiesner, Philipp Alexander is an individual health care provider with primary practice located at 3800 S National Ave , Springfield MO 65807-5209. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Wiesner, Philipp Alexander can be contacted via phone (417) 875-2718.

Contact Information

Primary practice address
3800 S National Ave Springfield MO 65807-5209
Phone: (417) 875-2718
Fax: (417) 875-3737
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X A126482 California
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 2019015689 Missouri

Profile Details

NPI number 1609162817
LBN Legal business name Wiesner, Philipp Alexander
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2011
Last updated Jul 7th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609162817 NPPES
Missouri MEDICAID 200069960

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