Individual
JEREMY ANDREW WISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
103 MEDICAL PARK FL 2, HATTIESBURG, MS 39401-9042
(601) 268-5630
(601) 579-3285
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 264-6000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
166939
FL
207X00000X
Orthopaedic Surgery Physician
LL82680
SC
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
35263
MS
Other
Enumeration date
06/05/2019
Last updated
08/18/2025
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