Provider Demographics
NPI:1295771152
Name:WHEELER, PATRICIA L (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:L
Last Name:WHEELER
Suffix:
Gender:F
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 5460
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80155-5410
Mailing Address - Country:US
Mailing Address - Phone:720-615-1730
Mailing Address - Fax:
Practice Address - Street 1:186 W ELLENDALE AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-1408
Practice Address - Country:US
Practice Address - Phone:971-900-4984
Practice Address - Fax:877-673-8233
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD18322207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR057179Medicaid
ORMD18322OtherOR LICENSE