Provider Demographics
NPI:1568177939
Name:WES J IRWIN MD MS INC
Entity Type:Organization
Organization Name:WES J IRWIN MD MS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WES
Authorized Official - Middle Name:J
Authorized Official - Last Name:IRWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD MS
Authorized Official - Phone:530-545-1175
Mailing Address - Street 1:2074 LAKE TAHOE BLVD STE 8
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-6417
Mailing Address - Country:US
Mailing Address - Phone:530-208-9355
Mailing Address - Fax:530-231-0601
Practice Address - Street 1:2074 LAKE TAHOE BLVD STE 8
Practice Address - Street 2:
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-6417
Practice Address - Country:US
Practice Address - Phone:530-208-9355
Practice Address - Fax:530-231-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-19
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty