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General NPI Number Information
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NPI Number | 1861493967
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Entity Type | Individual
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Provider Name | COREY W WESNER DPM
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Gender | Male
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 04/03/2012
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Provider Practice Location Address
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Address Line | 1440 S COMMERCIAL ST
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City | NEENAH
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State | WI
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Zip | 54956-4638
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Country | US
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Telephone | 920-725-4008
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Fax | 920-725-4218
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Provider Business Mailing Address
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Address Line | 1440 S COMMERCIAL ST
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City | NEENAH
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State | WI
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Zip | 54956-4638
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Country | US
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Telephone | 920-725-4008
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Fax | 920-725-4218
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 759-025
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 759-025
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License Number State | WI
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