Provider Demographics
NPI:1003036997
Name:WISE, CHRISTOPHER L (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:L
Last Name:WISE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:19550 E 39TH ST
Mailing Address - Street 2:STE 410
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057
Mailing Address - Country:US
Mailing Address - Phone:816-303-2400
Mailing Address - Fax:816-303-2484
Practice Address - Street 1:2790 CLAY EDWARDS DR STE 600
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3274
Practice Address - Country:US
Practice Address - Phone:816-561-3003
Practice Address - Fax:816-889-1584
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2018-04-02
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Provider Licenses
StateLicense IDTaxonomies
MO2008008638207X00000X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery