Individual
PETER WYZINSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1125 DARLENE LN, SUITE 100, EUGENE, OR 97401-1601
(541) 343-5000
(541) 344-9478
Mailing address
PO BOX 10888, EUGENE, OR 97440-2888
(541) 343-5000
(541) 344-9478
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD14320
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012381-0004
PACIFICARE/SECURE HORIZON
OR
05
—
143115
—
OR
Enumeration date
07/19/2006
Last updated
12/27/2007
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