MEDICARE: JONATHAN DAVID WECHLSER D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	804	NV

General Provider Information

NPI Number	:	1346393881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN DAVID WECHLSER D.O.

Provider Business Mailing Address
First Line	:	3227 E WARM SPRINGS RD
Second Line	:	SUITE 300
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3179
Country	:	US
Telephone Number	:	702-990-7035
Fax Number	:	702-990-7041

Provider Business Practice Location Address
First Line	:	3227 E WARM SPRINGS RD
Second Line	:	SUITE 300
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3179
Country	:	US
Telephone Number	:	702-990-7035
Fax Number	:	702-990-7041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	07/08/2007

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