Provider Demographics
NPI:1801105507
Name:WHEELER, JAIME K (MD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:K
Last Name:WHEELER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:K
Other - Last Name:WHEELER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1805
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89702-1805
Mailing Address - Country:US
Mailing Address - Phone:775-827-0111
Mailing Address - Fax:775-883-4306
Practice Address - Street 1:3690 GRANT DR
Practice Address - Street 2:SUITE A2
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-5476
Practice Address - Country:US
Practice Address - Phone:775-827-0111
Practice Address - Fax:775-883-4306
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-28
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV3479207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV3479OtherNEVADA STATE BOARD OF MEDICAL EXAMINERS
13028964OtherABMS
MN24457OtherMINNESOTA BOARD OF MEDICAL PRACTICE
CAC38180OtherTHE MEDICAL BOARD OF CALIFORNIA
D2627OtherTEXAS MEDICAL BOARD