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General NPI Number Information
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NPI Number | 1104494673
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Entity Type | Individual
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Provider Name | EMILY CAROLINE WHEAT MD
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Gender | Female
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 2511 W EDGEWOOD DR STE G
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City | JEFFERSON CITY
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State | MO
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Zip | 65109-5869
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Country | US
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Telephone | 573-761-0458
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Fax | 573-761-6957
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Provider Business Mailing Address
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Address Line | PO BOX 1027
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City | JEFFERSON CITY
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State | MO
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Zip | 65102-1027
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Country | US
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Telephone | 573-681-3767
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Fax | 573-681-3593
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R-12122
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2023047878
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License Number State | MO
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