Richard G Wise DO Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

34003728 Issued in OH

Legal business name

RICHARD G WISE DO INC

Practice address

11 Sycamore Drive
New Middletown, OH 44442

Phone

(330) 542-2881

Fax

(330) 542-0074

NPI assigned

Oct 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Richard G Wise, D.O.

Title

President

Phone

(330) 542-2881

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1193702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1164601746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 272",
            "city": "NEW MIDDLETOWN",
            "state": "OH",
            "postal_code": "444420272",
            "telephone_number": "330-542-2881",
            "fax_number": "330-542-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 SYCAMORE DRIVE",
            "city": "NEW MIDDLETOWN",
            "state": "OH",
            "postal_code": "44442",
            "telephone_number": "330-542-2881",
            "fax_number": "330-542-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD G WISE DO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-30",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "330-542-2881",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "OH",
            "license": "34003728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0598769",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• New Middletown Village Pharmacy Inc.
• Omni Manor, Inc.
• Phillip Arsuffi DMD LLC
• John Bennett Polansky, RT(R),RDCS,RVT
• Erica Porch
• Carrie Lynn Ritzler
• Mindy A Ritzler
• Nicole Saborse
• Springfield Local School District
• Robert Wayne Sutak, L.I.S.W-S.

• All providers in New Middletown, OH
• Primary Care Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.