Healthcare Provider Details

I. General information

NPI: 1699784967
Provider Name (Legal Business Name): DONALD CRAIG WHEELER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2006
Last Update Date: 04/26/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 RUSS ST
EUREKA CA
95501-4451
US

IV. Provider business mailing address

PO BOX 4947
EUREKA CA
95502-4947
US

V. Phone/Fax

Practice location:
  • Phone: 707-445-5431
  • Fax: 707-277-3001
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG62017
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: