| Dr John M Wise | |
|
2820 Napoleon Ave Suite 460 New Orleans LA 70115-6969 | |
| (504) 897-5121 | |
| (504) 897-9743 |
| Full Name | Dr John M Wise |
|---|---|
| Speciality | Internal Medicine |
| Location | 2820 Napoleon Ave, New Orleans, Louisiana |
| Authorized Official Name and Position | Kellie Robichaux (OFFICE MANAGER) |
| Authorized Official Contact | 5048975121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr John M Wise 2820 Napoleon Ave Suite 460 New Orleans LA 70115-6969 Ph: (504) 897-5121 | Dr John M Wise 2820 Napoleon Ave Suite 460 New Orleans LA 70115-6969 Ph: (504) 897-5121 |
| NPI Number | 1124488630 |
|---|---|
| Provider Enumeration Date | 02/25/2016 |
| Last Update Date | 03/15/2016 |
| Medicare PECOS PAC ID | 0648579953 |
|---|---|
| Medicare Enrollment ID | O20160509000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124488630 | NPI | - | NPPES |
| 1545759 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 12877R (Louisiana) | Primary |
| Provider Name | John M Wise |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477556496 PECOS PAC ID: 6901837400 Enrollment ID: I20050824000854 |
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