Individual
PETER F WISNIEWSKI I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
706 ROSS ST, OAK GROVE, LA 71263-9798
(318) 428-3237
(318) 428-1362
Mailing address
706 ROSS ST, OAK GROVE, LA 71263-9798
(318) 428-3237
(183) 428-1362
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
08960
MS
207Q00000X
Family Medicine Physician
323886
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07728748
—
MS
05
—
1554189
—
LA
Enumeration date
01/31/2006
Last updated
03/13/2025
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