| Keith Thomas Wiethaupt, | |
|
7827 Town Square Ave Ste 104, O Fallon, MO 63368-7199 | |
| (636) 734-0386 | |
| (636) 352-4173 |
| Full Name | Keith Thomas Wiethaupt |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Surgical |
| Location | 7827 Town Square Ave Ste 104, O Fallon, Missouri |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801718788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | 147974 (Missouri) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Keith Thomas Wiethaupt, 7827 Town Square Ave Ste 104, O Fallon, MO 63368-7199 Ph: (636) 734-0386 | Keith Thomas Wiethaupt, 7827 Town Square Ave Ste 104, O Fallon, MO 63368-7199 Ph: (636) 734-0386 |
Rebecca J. Smith, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 9209 Phoenix Village Pkwy, O Fallon, MO 63368 Phone: 636-561-4630 Fax: 636-561-4610 |
Riley B Busch, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1101 Highway K, O Fallon, MO 63366 Phone: 636-379-6363 |
Mrs. Krista N. Carter, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 7068 S Outer 364, O Fallon, MO 63368 Phone: 636-240-6100 Fax: 636-240-1182 |
Mrs. Patricia Ann Holschen, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 832 Brockwell Dr, O Fallon, MO 63368 Phone: 314-368-4842 |
James W Harris, CSFA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 7827 Town Square Ave Ste 104, O Fallon, MO 63368 Phone: 636-734-0386 |
Ms. Olivia Faeth Hasselfeld, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2 Progress Point Pkwy, Div Im Medical Oncology, O Fallon, MO 63368 Phone: 800-647-2098 Fax: 314-362-3192 |
Jessica D Blanke, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 7827 Highway N Ste 104, O Fallon, MO 63368 Phone: 636-377-1177 Fax: 636-377-1911 |