Provider Demographics
NPI:1659478287
Name:WHEELER, JOHN DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVID
Last Name:WHEELER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1125 S ROCK RD
Mailing Address - Street 2:STE. #7
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67207-3361
Mailing Address - Country:US
Mailing Address - Phone:316-618-5550
Mailing Address - Fax:316-618-5551
Practice Address - Street 1:1125 S ROCK RD
Practice Address - Street 2:STE. #7
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67207-3361
Practice Address - Country:US
Practice Address - Phone:316-618-5550
Practice Address - Fax:316-618-5551
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS4403111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS55024OtherBLUE CROSS BLUE SHIELD
KS055024Medicare ID - Type Unspecified