MEDICARE: DR. OLIVER JAYME WISCO D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ND0101X	MOHS-Micrographic Surgery Physician	DO157812	OR
2	207ND0101X	MOHS-Micrographic Surgery Physician	DO01032	RI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	12729019	OTHER	OR	CAQH
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164545166
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLIVER JAYME WISCO D.O.

Provider Business Mailing Address
First Line	:	15 LA SALLE SQ
Second Line	:
City	:	PROVIDENCE
State	:	RI
Zip	:	02903-1814
Country	:	US
Telephone Number	:	401-444-6779
Fax Number	:	401-444-6912

Provider Business Practice Location Address
First Line	:	DERMATOLOGY HEALTH SPCECIALIST
Second Line	:	1693 SW CHANDLER AVE SUITE 250
City	:	BEND
State	:	OR
Zip	:	97702-3231
Country	:	US
Telephone Number	:	541-382-8819
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	12/19/2025

Similar Medicare Providers

1245321082 — JASON M. KREMER D.C., CSCS
Practice Location Address:

1693 SW CHANDLER AVE STE 280
BEND, OR
97702-3231

Practice Phone: 541-318-1000
Practice Fax: 541-318-7050

1063630929 — DR. AMANDA WESTFALL MCCARTY DPM
Practice Location Address:

1693 SW CHANDLER AVE , SUITE 280
BEND, OR
97702-3231

Practice Phone: 541-385-7129
Practice Fax: 541-385-7138

1659627354 — MRS. LINDSEY JOHNSON CLARK PA-C
Practice Location Address:

1693 SW CHANDLER AVE STE 250
BEND, OR
97702-3231

Practice Phone: 541-382-8819
Practice Fax:

1669857181 — CENTRAL OREGON FOOT & ANKLE GROUP, INC.
Practice Location Address:

1693 SW CHANDLER AVE STE 280
BEND, OR
97702-3231

Practice Phone: 541-728-0858
Practice Fax: 844-622-7945

1447713573 — DERMATOLOGY HEALTH SPECIALISTS, PC
Practice Location Address:

1693 SW CHANDLER AVE STE 250
BEND, OR
97702-3231

Practice Phone: 210-632-5544
Practice Fax:

1629342480 — DR. ANTHONY JOHN PELEZO M.D.
Practice Location Address:

3231 WILLOW BEND TRL
ZIONSVILLE, IN
46077-4412

Practice Phone: 314-368-6595
Practice Fax:

Directions to “ DR. OLIVER JAYME WISCO D.O.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.