Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 39501 | IA |
Y | 207K00000X | Allergist & Immunologist | 75044 | WI |
N | 207RA0201X | Internist - Allergy & Immunology | 39501 | IA |
NPI | 1790994390 |
---|---|
Provider Name | Dr. John P. Wheeler JR. |
First Address | Rochester, MN 55905-0001 |
Second Address | La Crosse, WI 54601-8806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 30/04/2021 |