# JOHN E. WISE MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417042623
- **Authorized official:** DR. JOHN EDNEY WISE MD (PRESIDENT)
- **Authorized official phone:** (828) 328-2094

## Contact information

- **Practice address:** 11 13TH AVE NE, SUITE 103, HICKORY, NC 28601-3700
- **Practice address phone:** (828) 328-2094
- **Practice address fax:** (828) 328-8980
- **Mailing address:** 11 13TH AVE NE, SUITE 103, HICKORY, NC 28601-3700
- **Mailing address phone:** (828) 328-2094
- **Mailing address fax:** (828) 328-8980

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | 11979 | NC | Yes |

## Other

- **Enumeration date:** 10/04/2006
- **Last updated:** 07/07/2008