Provider Demographics
NPI:1346393881
Name:WECHLSER, JONATHAN DAVID (DO)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:DAVID
Last Name:WECHLSER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3227 E WARM SPRINGS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89120-3179
Mailing Address - Country:US
Mailing Address - Phone:702-990-7035
Mailing Address - Fax:702-990-7041
Practice Address - Street 1:3227 E WARM SPRINGS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-3179
Practice Address - Country:US
Practice Address - Phone:702-990-7035
Practice Address - Fax:702-990-7041
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV804207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV31421Medicare ID - Type Unspecified
NVE76495Medicare UPIN