| Dr Mark Edwin Wisner, PHD, PA-C | |
|
4101 S 4th St, Vamc Rm. A541, Leavenworth, KS 66048-5014 | |
| (913) 758-5416 | |
| (913) 758-4219 |
| Full Name | Dr Mark Edwin Wisner |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant - Medical |
| Location | 4101 S 4th St, Leavenworth, Kansas |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598771586 | NPI | - | NPPES |
| 100340730A | Medicaid | KS | |
| 426715 | Other | KS | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA 15-000385 (Kansas) | Primary |
| 363AS0400X | Physician Assistant - Surgical | PA-15-000385 (Kansas) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark Edwin Wisner, PHD, PA-C 4101 S 4th St, Vamc Rm. A541, Leavenworth, KS 66048-5014 Ph: (913) 758-5416 | Dr Mark Edwin Wisner, PHD, PA-C 4101 S 4th St, Vamc Rm. A541, Leavenworth, KS 66048-5014 Ph: (913) 758-5416 |
Charles C Glass, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3550 S 4th St Ste 250, Leavenworth, KS 66048 Phone: 913-565-2569 Fax: 913-565-2571 | |
Jarod Joseph Marcotte, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3550 S 4th St Ste 200, Leavenworth, KS 66048 Phone: 913-680-6442 Fax: 913-351-1346 | |
Mr. Douglas A Kaufman, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4101 S 4th St, Leavenworth, KS 66048 Phone: 913-682-2000 | |
Lorree Huffman, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4101 S 4th St, Leavenworth, KS 66048 Phone: 913-682-2000 Fax: 913-758-4119 | |
Wanda Johnston, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4101 S 4th St, Leavenworth, KS 66048 Phone: 913-758-9600 | |
Thuy Le Petersen, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1300 Metropolitan Ave, Leavenworth, KS 66048 Phone: 913-682-8700 | |
Jill Marie Davis, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 500 Limit St, Leavenworth, KS 66048 Phone: 913-682-5118 Fax: 913-682-4664 |