Organization
EDWARD L WIEBE DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD L WIEBE DPM (PRESIDENT)
(928) 226-7555
Entity
Organization
Contact information
Practice address
8 W COLUMBUS AVE, FLAGSTAFF, AZ 86001-3202
(928) 226-7555
(928) 226-0014
Mailing address
8 W COLUMBUS AVE, FLAGSTAFF, AZ 86001-3202
(928) 226-7555
(928) 226-0014
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
0076
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2Z6682
HEALTHNET
AZ
01
—
480627039
RAILROAD MEDICARE
AZ
Enumeration date
09/22/2011
Last updated
09/22/2011
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