Individual
DR. ERIC P WIESNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 TESSITORE CT, SUITE B, MONTROSE, CO 81401-5689
(970) 787-4710
(970) 615-7007
Mailing address
2643 PATTERSON RD, SUITE 503, GRAND JUNCTION, CO 81506-1937
(970) 245-2400
(970) 242-9092
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
DR.0062163
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000175731
—
CO
Enumeration date
03/24/2013
Last updated
04/01/2021
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