Healthcare Provider Details

I. General information

NPI: 1265876213
Provider Name (Legal Business Name): JOHN LEN WHEAT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2013
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 VINE ST
CLINTON IN
47842
US

IV. Provider business mailing address

PO BOX 545
CLINTON IN
47842-0545
US

V. Phone/Fax

Practice location:
  • Phone: 765-592-3381
  • Fax: 765-820-1105
Mailing address:
  • Phone: 765-832-6977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number01078016A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number01078016A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number01078016A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: