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Individual

DR. JEFFREY C WIENKE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM CWSP

Contact information

Practice address
1150 N 83RD ST, LINCOLN, NE 68505-2094
(402) 483-4485
Mailing address
1150 N 83RD ST, LINCOLN, NE 68505-2094
(402) 483-4485

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
000820
IA
213E00000X
Podiatrist
206
SD
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
345
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
47-0836558
TAX ID
NE
Enumeration date
07/03/2009
Last updated
08/16/2017
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