Healthcare Provider Details

I. General information

NPI: 1194752923
Provider Name (Legal Business Name): WILLIAM E WESSELS JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5200 HUMMINGBIRD RD SUITE 100
WAUSAU WI
54401-6312
US

IV. Provider business mailing address

5200 HUMMINGBIRD RD SUITE 100
WAUSAU WI
54401-6312
US

V. Phone/Fax

Practice location:
  • Phone: 715-359-6442
  • Fax: 715-393-0391
Mailing address:
  • Phone: 715-359-6442
  • Fax: 715-393-0391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number31628
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number31628
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number31628
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: