Individual
RONALD E WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1435 WAZEE ST, # 101, DENVER, CO 80202-1491
(303) 299-9473
(303) 299-9472
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
34013
CO
207WX0120X
Cornea and External Diseases Specialist Physician
Primary
34013
CO
208600000X
Surgery Physician
34013
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0815699
AETNA
CO
01
—
106500
KS BLUE SHIELD
KS
05
—
1340132
—
CO
01
—
1467405928
GROUP NPI
—
01
—
180025514
RAILROAD MEDICARE
CO
01
—
1841407392
KS NPI
—
01
—
18827
SPECTERA
CO
05
—
200539900A
—
KS
01
—
34013
VISION BENEFITS OF AMER
CO
01
—
41535
AVESIS
CO
01
—
841353910
TAX ID#
CO
01
—
919991020591
EYE SPECIALISTS
CO
01
—
CO4013
EYEMED
CO
01
—
WI12401
CO BLUE SHIELD
CO
Enumeration date
08/19/2005
Last updated
03/28/2018
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