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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609162817 | NPPES |
| Missouri | MEDICAID | 200069960 |
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