JEREMY ANDREW WISE MD NPI 1912565763

NPI Information

  • NPI: 1912565763
  • Provider Name: JEREMY ANDREW WISE, MD
  • Classification: Orthopaedic Surgery - 207XS0114X
  • Specialization: Adult Reconstructive Orthopaedic Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 103 MEDICAL PARK FL 2
    HATTIESBURG, MS
    ZIP 39401
  • Phone: (601) 268-5630

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NPI Details

Jeremy Andrew Wise, MD is an adult reconstructive orthopaedic surgery orthopaedic surgery in Hattiesburg, MS with 7 years of experience. The provider is recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. Jeremy Andrew Wise, MD NPI is 1912565763. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduation Year:2019

The provider's business location address is:

103 MEDICAL PARK FL 2
HATTIESBURG, MS
ZIP 39401-042
Phone: (601) 268-5630
Fax: (601) 579-3285

The NPI 1912565763 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/5/2019 and was last updated on 8/18/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207X00000XOrthopaedic Surgery166939FLORIDANo
2207X00000XOrthopaedic SurgeryLL82680SOUTH CAROLINANo
3207XS0114XOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery35263MISSISSIPPIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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