Organization
GENERAL & GYN SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD A WIETHOFF MD (PRESIDENT)
(812) 522-2177
Entity
Organization
Contact information
Practice address
225 S PINE ST, SUITE 310, SEYMOUR, IN 47274-2365
(812) 522-2177
(812) 522-4069
Mailing address
225 S PINE ST, SUITE 310, SEYMOUR, IN 47274-2365
(812) 522-2177
(812) 522-4069
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
50001933A
IN
Other
Enumeration date
07/15/2006
Last updated
08/22/2020
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