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General NPI Number Information
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NPI Number | 1023412038
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Entity Type | Organization
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Legal Business Name | JEFFREY S. WUNNING, DPM, LLC.
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 10/20/2014
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Provider Practice Location Address
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Address Line | 950 FORESTBROOK LN
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City | PAINESVILLE
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State | OH
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Zip | 44077-7604
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Country | US
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Telephone | 419-524-2875
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Fax |
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Provider Business Mailing Address
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Address Line | 950 FORESTBROOK LN
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City | PAINESVILLE
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State | OH
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Zip | 44077-7604
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. MICHAEL F. BARRON
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Credential | MHSA
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Telephone | 419-524-2875
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 003661
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License Number State | OH
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