Individual
DR. TIMOTHY W WYSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2222 N NEVADA AVE, COLORADO SPRINGS, CO 80907
(719) 776-8040
(719) 776-8050
Mailing address
2222 N NEVADA AVE, COLORADO SPRINGS, CO 80907-6819
(719) 776-8040
(719) 776-8050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
30194
CO
208M00000X
Hospitalist Physician
Primary
DR.0030194
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01301944
—
CO
Enumeration date
10/21/2005
Last updated
07/09/2018
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