Individual
THOMAS WATKINS WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
128 MEDICAL CIR, WINCHESTER, VA 22601-3322
(540) 667-8975
(540) 667-6589
Mailing address
128 MEDICAL CIR, WINCHESTER, VA 22601-3322
(540) 667-8975
(540) 667-6589
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101227106
VA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
0101227106
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200039661
MEDICARE RAILROAD
—
05
—
6401686
—
VA
01
—
P00776570
RAILROAD MEDICARE
—
Enumeration date
06/27/2006
Last updated
12/07/2023
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