Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 31628 | WI |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 31628 | WI |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 31628 | WI |
NPI | 1194752923 |
---|---|
Provider Name | William E Wessels JR. |
First Address | Wausau, WI 54401-6312 |
Second Address | Wausau, WI 54401-6312 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 13/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
31625900 | (05) | WI |
BW2382961 | DEA # (01) | |
E67665 | (02) | WI |