MEDICARE: JENNIFER RENEE WISE MD

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	207R00000X	Internal Medicine Physician	12016	NH
2	207R00000X	Internal Medicine Physician	MD192270	OR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00179641	OTHER	NH	RR MEDICARE PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	3369774	OTHER	NH	AETNA PROV #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	6000361	OTHER	NH	HPHC PIN
5	101115805	OTHER	NH	DOL W/C PIN
6	30367Y	OTHER	NH	RAN PIN
7	5796012	OTHER	NH	CIGNA PIN
8	012016	OTHER	NH	TUFTS PIN
9	01YP05180NH01	OTHER	NH	ANTHEM ACES PIN

General Provider Information

NPI Number	:	1255326252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER RENEE WISE MD

Provider Business Mailing Address
First Line	:	2865 DAGGETT AVE
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1106
Country	:	US
Telephone Number	:	541-274-8400
Fax Number	:	541-274-8405

Provider Business Practice Location Address
First Line	:	2821 DAGGETT AVE STE 200
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1106
Country	:	US
Telephone Number	:	541-274-8400
Fax Number	:	541-274-8405

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	02/11/2020

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1386598043 — ANDREA CHEN CHIOU PA-C
Practice Location Address:

2865 DAGGETT AVE
KLAMATH FALLS, OR
97601-1106

Practice Phone: 541-882-6311
Practice Fax:

1083614630 — MS. DARCY R. BUTCHER FNPC
Practice Location Address:

2821 DAGGETT AVE STE 200
KLAMATH FALLS, OR
97601-1106

Practice Phone: 541-274-8400
Practice Fax: 541-274-8405

1942296678 — FRANK GEOFFREY MARX MD
Practice Location Address:

2865 DAGGETT AVE
KLAMATH FALLS, OR
97601-1106

Practice Phone: 541-274-6311
Practice Fax: 541-884-0730

1801883319 — DR. JEFFREY BRYAN WALKER M.D.
Practice Location Address:

2865 DAGGETT AVE
KLAMATH FALLS, OR
97601-1106

Practice Phone: 541-882-6311
Practice Fax:

1083688360 — MIGUEL MONTES MD
Practice Location Address:

2865 DAGGETT AVE
KLAMATH FALLS, OR
97601-1106

Practice Phone: 541-664-5151
Practice Fax:

Directions to “ JENNIFER RENEE WISE MD” 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 © 2007-2026 (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.