Patrick J Wedlake DO PC

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

DO16364 Issued in OR

Legal business name

PATRICK J WEDLAKE DO PC

Practice address

85O Siskiyou Blvd
Ste 9
Ashland, OR 97520-2125

Phone

(541) 482-0342

Fax

(541) 482-6986

NPI assigned

Oct 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Patrick John Wedlake, DO

Title

Director

Phone

(541) 864-0278

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1427301035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 SISKIYOU BLVD",
            "address_2": "STE 7",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202125",
            "telephone_number": "541-482-0342",
            "fax_number": "541-482-6986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85O SISKIYOU BLVD",
            "address_2": "STE 9",
            "city": "ASHLAND",
            "state": "OR",
            "postal_code": "975202125",
            "telephone_number": "541-482-0342",
            "fax_number": "541-482-6986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK J WEDLAKE DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "WEDLAKE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "541-864-0278",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "OR",
            "license": "DO16364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012828",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neuromusculoskeletal Medicine & OMM Physician in Ashland, OR
• Providers in Ashland, OR by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.