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NPI Code Detail

MEDICARE: WESLEY WAYNE HISER M.D.

MEDICARE: WESLEY WAYNE HISER M.D.
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
1207RC0000XCardiovascular Disease Physician2558AWY
2207RI0011XInterventional Cardiology Physician2558AWY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1060022914OTHERWYRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3305072OTHERWYBCBS

General Provider Information

NPI Number : 1760429799
Entity Type Code : Individual
Provider Name (Legal Business Name) : WESLEY WAYNE HISER M.D.
Provider Business Mailing Address
First Line : 1230 E 1ST ST
Second Line :
City : CASPER
State : WY
Zip : 82601-2704
Country : US
Telephone Number : 307-266-3174
Fax Number : 307-261-6713
Provider Business Practice Location Address
First Line : 1230 E 1ST ST
Second Line :
City : CASPER
State : WY
Zip : 82601-2704
Country : US
Telephone Number : 307-266-3174
Fax Number : 307-261-6713
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/31/2006
Last Update Date : 01/23/2015

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Directions to “ WESLEY WAYNE HISER M.D.” Practice Location

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