MEDICARE: MICAELA PATRICIA WEXLER 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	2084P0800X	Psychiatry Physician	2010005431	MO

General Provider Information

NPI Number	:	1265631527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICAELA PATRICIA WEXLER D.O.

Provider Business Mailing Address
First Line	:	12306 PAWNEE LN
Second Line	:
City	:	LEAWOOD
State	:	KS
Zip	:	66209-1407
Country	:	US
Telephone Number	:	913-948-0688
Fax Number	:	913-261-9634

Provider Business Practice Location Address
First Line	:	4203 BOOTH ST
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66103-3116
Country	:	US
Telephone Number	:	913-948-0688
Fax Number	:	913-261-9634

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

Provider Enumeration Date	:	07/16/2007
Last Update Date	:	11/14/2016

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