Individual
DR. ROBERT JAMES WENZLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
928 GOODMAN RD E, SUITE D, SOUTHAVEN, MS 38671-8824
(662) 470-4608
(662) 470-4610
Mailing address
928 GOODMAN RD E, SUITE D, SOUTHAVEN, MS 38671-8824
(662) 470-4608
(662) 470-4610
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
DPM0000000655
TN
213ES0131X
Foot Surgery Podiatrist
Primary
80196
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00464002
MEDICARE ID TYPE UNSPECIFIED
TN
Enumeration date
07/07/2006
Last updated
08/03/2009
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