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Individual

DR. GEORGIA L WIESNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3601 THE VANDERBILT CLINIC, NASHVILLE, TN 37232-5100
(615) 322-3000
Mailing address
3841 GREEN HILLS VILLAGE DR STE 200, NASHVILLE, TN 37215-2691
(615) 322-3000

Taxonomy

Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
35067621
OH
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
MD48589
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000224342
UNISON
OH
01
000000529595
ANTHEM
OH
01
0995393
BCMH
OH
05
0995393
OH
01
364132
WELLCARE
OH
01
4614845
AETNA
OH
01
745997
BUCKEYE
OH
Enumeration date
08/09/2005
Last updated
03/17/2022
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