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General NPI Number Information
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NPI Number | 1477743250
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Entity Type | Organization
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Legal Business Name | H. JAMES WIESMAN , JR, M.D.
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Dates
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Enumeration Date | 07/27/2007
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Last Update Date | 05/04/2023
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Provider Practice Location Address
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Address Line | 1412 TROTWOOD AVE STE 82
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City | COLUMBIA
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State | TN
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Zip | 38401-4982
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Country | US
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Telephone | 931-388-3104
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Fax | 931-381-1096
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Provider Business Mailing Address
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Address Line | 1412 TROTWOOD AVE STE 82
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City | COLUMBIA
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State | TN
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Zip | 38401-4982
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Country | US
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Telephone | 931-388-3104
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Fax | 931-381-1096
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. JENNIFER BAKER
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Credential |
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Telephone | 931-388-3104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD010397
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License Number State | TN
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