Wise, Jessica

Wise, Jessica is an individual health care provider with primary practice located at 320 Racetrack Rd Nw Ste 100B , Fort Walton Beach FL 32547-1796. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Trauma Surgery, Allopathic & Osteopathic Physicians / Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Surgical Critical Care. Allopathic & Osteopathic Physicians / Surgical Critical Care is her primary health care specialty. Wise, Jessica can be contacted via phone (850) 374-9610.

Contact Information

Primary practice address
320 Racetrack Rd Nw Ste 100B Fort Walton Beach FL 32547-1796
Phone: (850) 374-9610
Fax: (850) 374-9611
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Trauma Surgery 2086S0127X 158015 Florida
Allopathic & Osteopathic Physicians / Surgery 208600000X 158015 Florida
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Surgical Critical Care 2086S0102X 158015 Florida

Profile Details

NPI number 1336594050
LBN Legal business name Wise, Jessica
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2016
Last updated Jul 26th, 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 1336594050 NPPES
Nevada MEDICAID 1336594050

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