Individual
DR. ERIC ANDREW WIEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 E BROADWAY AVE STE 229, JACKSON, WY 83001-8640
(307) 739-7690
(307) 739-7644
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 739-7690
(307) 739-7644
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
10897A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145089100
—
WY
Enumeration date
04/16/2007
Last updated
02/24/2021
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