Individual
JAMES K. WIESNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9601 TOWNLINE RD, MINOCQUA, WI 54548-1390
(715) 358-1000
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
19602
WI
207R00000X
Internal Medicine Physician
19602
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30124400
—
WI
Enumeration date
02/13/2007
Last updated
11/16/2011
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