Individual
JASON ANDREW WIECHERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4700 MEMORIAL DR STE 340, BELLEVILLE, IL 62226-5373
(618) 234-9884
Mailing address
4700 MEMORIAL DR STE 340, BELLEVILLE, IL 62226-5373
(618) 234-9884
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036150728
IL
207X00000X
Orthopaedic Surgery Physician
2014022165
MO
207X00000X
Orthopaedic Surgery Physician
5101023734
MI
Other
Enumeration date
07/02/2014
Last updated
03/31/2021
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