# EDWARD L WIEBE DPM PC

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

## Provider details

- **NPI number:** 1598048837
- **Authorized official:** DR. EDWARD L WIEBE DPM (PRESIDENT)
- **Authorized official phone:** (928) 226-7555

## Contact information

- **Practice address:** 8 W COLUMBUS AVE, FLAGSTAFF, AZ 86001-3202
- **Practice address phone:** (928) 226-7555
- **Practice address fax:** (928) 226-0014
- **Mailing address:** 8 W COLUMBUS AVE, FLAGSTAFF, AZ 86001-3202
- **Mailing address phone:** (928) 226-7555
- **Mailing address fax:** (928) 226-0014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 0076 | AZ | Yes |

## Other

- **Enumeration date:** 09/22/2011
- **Last updated:** 09/22/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2Z6682 | HEALTHNET | AZ |
| 01 | — | 480627039 | RAILROAD MEDICARE | AZ |