Provider Demographics
NPI:1730270786
Name:WHEELER, HAROLD J (MD)
Entity type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:J
Last Name:WHEELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1179
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38935-1179
Mailing Address - Country:US
Mailing Address - Phone:662-455-6767
Mailing Address - Fax:662-455-1774
Practice Address - Street 1:517 HIGHWAY 82 W
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:MS
Practice Address - Zip Code:38930-5030
Practice Address - Country:US
Practice Address - Phone:662-455-6767
Practice Address - Fax:662-455-1774
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2010-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS10035207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS110138588OtherRAILROAD MEDICARE
MS06785238Medicaid
MS110016319OtherRAILROAD MEDICARE NUMBER
MS06785238Medicaid
MS110016319OtherRAILROAD MEDICARE NUMBER