Individual
DR. ANDREW R WYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2305 S HIGHWAY 65 BLDG A, MARSHALL, MO 65340-3702
(660) 886-7800
(660) 831-3306
Mailing address
2305 S HIGHWAY 65 BLDG A, MARSHALL, MO 65340-3702
(660) 886-7800
(660) 831-3306
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01045516
IN
207Q00000X
Family Medicine Physician
Primary
2018015413
MO
207V00000X
Obstetrics & Gynecology Physician
01045516A
IN
208M00000X
Hospitalist Physician
2018015413
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200064758
—
MO
05
—
200105220
—
IN
Enumeration date
10/19/2005
Last updated
03/05/2024
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