Individual
JOHN HENRY WISNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6522 HEDGE LANE TER, #201, SHAWNEE, KS 66226-4872
(913) 972-5730
Mailing address
6522 HEDGE LANE TER, #201, SHAWNEE, KS 66226-4872
(913) 972-5730
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04-17397
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100372770A
—
KS
05
—
205162605
—
MO
01
—
27574013
BCBS KANSAS CITY
MO
Enumeration date
08/30/2006
Last updated
07/23/2014
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