Individual
BRANDON J WIESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
900 E BATTLEFIELD ST STE 124, SPRINGFIELD, MO 65807-5208
(417) 986-1289
Mailing address
900 E BATTLEFIELD ST STE 124, SPRINGFIELD, MO 65807-5208
(417) 986-1289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2019006634
MO
207Q00000X
Family Medicine Physician
Primary
P8564
TX
Other
Enumeration date
06/17/2011
Last updated
03/13/2026
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