| Wise Psychiatry, Pc | |
|
6053 S Quebec St Ste 203 Centennial CO 80111-4505 | |
| (720) 708-4287 | |
| (720) 815-2581 |
| Full Name | Wise Psychiatry, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 6053 S Quebec St Ste 203, Centennial, Colorado |
| Authorized Official Name and Position | Brian Keith Wise (PRESIDENT) |
| Authorized Official Contact | 7207084287 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wise Psychiatry, Pc 6053 S Quebec St Ste 203 Centennial CO 80111-4505 Ph: (720) 708-4287 | Wise Psychiatry, Pc 6053 S Quebec St Ste 203 Centennial CO 80111-4505 Ph: (720) 708-4287 |
| NPI Number | 1548552656 |
|---|---|
| Provider Enumeration Date | 05/07/2011 |
| Last Update Date | 10/16/2024 |
| Certification Date | 10/16/2024 |
| Medicare PECOS PAC ID | 2668709726 |
|---|---|
| Medicare Enrollment ID | O20190812003671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548552656 | NPI | - | NPPES |
| 70583072 | Medicaid | CO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 41287 (Colorado) | Primary |
| Provider Name | Brian K Wise |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043211683 PECOS PAC ID: 7012959836 Enrollment ID: I20050523000642 |
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