Provider Demographics
NPI:1649087032
Name:JONATHAN W WHEELER MD INC
Entity type:Organization
Organization Name:JONATHAN W WHEELER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-815-2578
Mailing Address - Street 1:999 ADAMS ST STE 303
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENA
Mailing Address - State:CA
Mailing Address - Zip Code:94574-1173
Mailing Address - Country:US
Mailing Address - Phone:707-963-3658
Mailing Address - Fax:707-963-1775
Practice Address - Street 1:999 ADAMS ST STE 303
Practice Address - Street 2:
Practice Address - City:SAINT HELENA
Practice Address - State:CA
Practice Address - Zip Code:94574-1173
Practice Address - Country:US
Practice Address - Phone:707-963-3658
Practice Address - Fax:707-963-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty