Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2008008638 | MO |
Y | 207XX0801X | Orthopaedic Trauma Surgeon | 2008008638 | MO |
NPI | 1003036997 |
---|---|
Provider Name | Christopher L Wise |
First Address | Independence, MO 64057 |
Second Address | Kansas City, MO 64116-3274 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 02/04/2018 |