| Wiseman Family Practice Co PLLC | |
|
1500 N Grant St # 5963 Denver CO 80203-1859 | |
| (512) 345-8970 | |
| (855) 220-9655 |
| Full Name | Wiseman Family Practice Co PLLC |
|---|---|
| Speciality | Family Medicine |
| Location | 1500 N Grant St # 5963, Denver, Colorado |
| Authorized Official Name and Position | Jeremy D Wiseman (MANAGING PARTNER) |
| Authorized Official Contact | 5123458970 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wiseman Family Practice Co PLLC 2500 S Lakeline Blvd Ste 100 Cedar Park TX 78613-2968 Ph: (512) 345-8970 | Wiseman Family Practice Co PLLC 1500 N Grant St # 5963 Denver CO 80203-1859 Ph: (512) 345-8970 |
| NPI Number | 1295602183 |
|---|---|
| Provider Enumeration Date | 10/23/2025 |
| Last Update Date | 10/23/2025 |
| Certification Date | 10/23/2025 |
| Medicare PECOS PAC ID | 5092296467 |
|---|---|
| Medicare Enrollment ID | O20260224001906 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295602183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
| Provider Name | Jeremy Douglas Wiseman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114188497 PECOS PAC ID: 7810180171 Enrollment ID: I20260224001986 |
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