Individual
DR. JAMES A WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD CCC A
Contact information
Practice address
9119 W 74TH ST STE 306, SHAWNEE MISSION, KS 66204-2229
(913) 403-0018
(913) 432-3619
Mailing address
7301 MISSION RD STE 146, PRAIRIE VILLAGE, KS 66208-3005
(913) 384-2105
(913) 384-0735
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
285
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100227760A
—
KS
01
—
4254145
AETNA
—
01
—
481106646
HUMANA
—
01
—
640002259
TRAVELERS MEDICARE
—
01
—
CE614
HEARING AID DISPENSING
KS
01
—
R89345
COVENTRY
—
Enumeration date
03/02/2006
Last updated
10/27/2008
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