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General NPI Number Information
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NPI Number | 1548237159
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Entity Type | Individual
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Provider Name | JAMES A WISE PHD CCC A
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Gender | Male
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Dates
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Enumeration Date | 03/02/2006
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Last Update Date | 10/27/2008
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Provider Practice Location Address
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Address Line | 9119 W 74TH ST STE 306
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City | SHAWNEE MISSION
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State | KS
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Zip | 66204-2229
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Country | US
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Telephone | 913-403-0018
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Fax | 913-432-3619
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Provider Business Mailing Address
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Address Line | 7301 MISSION RD STE 146
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City | PRAIRIE VILLAGE
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State | KS
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Zip | 66208-3005
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Country | US
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Telephone | 913-384-2105
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Fax | 913-384-0735
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | 285
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License Number State | KS
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