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General NPI Number Information
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NPI Number | 1467405928
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Entity Type | Organization
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Legal Business Name | RONALD E WISE MD PC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 09/20/2011
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Provider Practice Location Address
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Address Line | 1435 WAZEE ST #101
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City | DENVER
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State | CO
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Zip | 80202-1491
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Country | US
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Telephone | 303-299-9473
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Fax | 303-299-9472
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Provider Business Mailing Address
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Address Line | 1435 WAZEE ST # 101
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City | DENVER
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State | CO
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Zip | 80202-1491
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Country | US
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Telephone | 303-299-9473
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Fax | 303-299-9472
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Authorized Official
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Title or Position | OWNER
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Name | RONALD E WISE
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Credential | M.D.
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Telephone | 303-299-9473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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