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NPI Code Detail

MEDICARE: BRIAN D WOLFE MD

MEDICARE: BRIAN D WOLFE MD
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
1207Q00000XFamily Medicine Physician04-18769KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396749172
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIAN D WOLFE MD
Provider Business Mailing Address
First Line : PO BOX 1832
Second Line :
City : PITTSBURG
State : KS
Zip : 66762-1832
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2051 N STATE ST
Second Line :
City : IOLA
State : KS
Zip : 66749-4402
Country : US
Telephone Number : 620-380-6600
Fax Number : 620-380-6215
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2005
Last Update Date : 01/17/2025

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Directions to “ BRIAN D WOLFE MD” Practice Location

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