Provider Demographics
NPI:1134138308
Name:WHEELER, DWIGHT E (MD)
Entity Type:Individual
Prefix:
First Name:DWIGHT
Middle Name:E
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 8035
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-0035
Mailing Address - Country:US
Mailing Address - Phone:316-689-9135
Mailing Address - Fax:316-689-9102
Practice Address - Street 1:720 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:KS
Practice Address - Zip Code:67114-8778
Practice Address - Country:US
Practice Address - Phone:316-284-5150
Practice Address - Fax:316-284-5110
Is Sole Proprietor?:No
Enumeration Date:2006-08-06
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS18493207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS027967OtherBCBS
KS16874OtherCOVENTRY
KS1007OtherPHS
KS12149417OtherMULTIPLAN
KS100407OtherHPK
KS16874OtherCOVENTRY
KS12149417OtherMULTIPLAN