Individual
BENJAMIN ERNEST WISEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801
(662) 377-4394
(662) 377-7045
Mailing address
PO BOX 3294, TUPELO, MS 38803
(662) 377-4394
(662) 377-7045
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
18380
MS
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
18380
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00681735
—
MS
Enumeration date
08/07/2006
Last updated
09/11/2025
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