Elise R Wiesner MD PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

18219 Issued in OK

Legal business name

ELISE R WIESNER MD PC

Practice address

900 N Porter Ave
Suite 310
Norman, OK 73071-6424

Phone

(405) 329-7066

Fax

(405) 360-6315

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Elise R Wiesner, M.D.

Title

Owner

Phone

(405) 329-7066

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200960000000",
    "number": "1396790754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 N PORTER AVE",
            "address_2": "SUITE 310",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716424",
            "telephone_number": "405-329-7066",
            "fax_number": "405-360-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N PORTER AVE",
            "address_2": "SUITE 310",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730716424",
            "telephone_number": "405-329-7066",
            "fax_number": "405-360-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELISE R WIESNER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-01-22",
        "status": "A",
        "authorized_official_last_name": "WIESNER",
        "authorized_official_first_name": "ELISE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-329-7066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OK",
            "license": "18219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100826940A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Norman, OK
• Providers in Norman, OK by specialty
• Internal Medicine Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2008; 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.