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Individual

JEFFREY M WISSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
830 W HIGH ST, SUITE 360, LIMA, OH 45801-3971
(419) 227-7117
(419) 227-2848
Mailing address
PO BOX 636930, CINCINNATI, OH 45263-6930
(513) 981-5123
(513) 981-5015

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34007802
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2332818
OH
01
P00240059
RAILROAD MEDICARE
OH
Enumeration date
07/13/2005
Last updated
06/21/2017
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