# DR. JEFFREY C WIENKE JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1629207261
- **Gender:** Man
- **Credential:** DPM CWSP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213E00000X | Podiatrist | 000820 | IA | — |
| 213E00000X | Podiatrist | 206 | SD | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 345 | NE | Yes |

## Other

- **Enumeration date:** 07/03/2009
- **Last updated:** 08/16/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 47-0836558 | TAX ID | NE |