NPIMap

Organization Active NPI

Wilhelm Tietke MD PC

  • Gastroenterology Physician
  • Huntsville, AL
National Provider Identifier
1417204686
Registry record updated Aug 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
7067 Issued in AL
Legal business name
WILHELM TIETKE MD PC
Practice address
131 Longwood Dr SW
Huntsville, AL 35801-4522
Phone
(256) 880-9628
Fax
(256) 880-9629
NPI assigned
Aug 7, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2012

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

Authorized official

Name
Dr. Wilhelm Tietke, MD
Title
Physician/Owner
Phone
(256) 880-9628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X 7067 AL Primary

Addresses

Primary practice location

131 Longwood Dr SW
Huntsville, AL 35801-4522

Mailing address

131 Longwood Dr SW
Huntsville, AL 35801-4522
Phone (256) 880-9628

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344297600000",
    "number": "1417204686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 LONGWOOD DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014522",
            "telephone_number": "256-880-9628",
            "fax_number": "256-880-9629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 LONGWOOD DR SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014522",
            "telephone_number": "256-880-9628",
            "fax_number": "256-880-9629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILHELM TIETKE MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-07",
        "last_updated": "2012-08-07",
        "status": "A",
        "authorized_official_last_name": "TIETKE",
        "authorized_official_first_name": "WILHELM",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "256-880-9628",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AL",
            "license": "7067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2012; 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.