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NPI Code Detail

MEDICARE: JOHN JEFFRIES WRENN MD

MEDICARE: JOHN JEFFRIES WRENN 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
1208800000XUrology Physician33325NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
189277OTHERNCBLUE CROSS CLUE SHIELD NC
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659372019
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN JEFFRIES WRENN MD
Provider Business Mailing Address
First Line : 509 N ELAM AVE FL 2
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-1157
Country : US
Telephone Number : 336-274-1114
Fax Number : 336-232-5325
Provider Business Practice Location Address
First Line : 509 N ELAM AVE FL 2
Second Line :
City : GREENSBORO
State : NC
Zip : 27403-1157
Country : US
Telephone Number : 336-274-1114
Fax Number : 336-232-5325
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/09/2005
Last Update Date : 02/11/2011

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