Individual
JORDAN WIEBE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
330 CEDAR ST BLDG 3, NEW HAVEN, CT 06510-3218
(203) 785-2571
Mailing address
545 BARNHILL DR, INDIANAPOLIS, IN 46202-5112
(317) 278-0394
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
80521
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2019
Last updated
05/14/2025
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