NPI
Gary Royce Wisner
NPI 1528175841
Read from the NPPES registry on October 26, 2026.
Facts
- Status
- Active
- Credential
- M.D.
- Type
- Individual
- Enumeration date
- 2006-08-23
- Last updated
- 2008-05-14
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Specialties
Licenses
- License CA
- A41236
Location
- Practice location
- 621 S Ham Ln Ste A
- City
- Lodi CA
- Postal code
- 95242-3533
- Phone
- (209) 368-7777
- Fax
- (209) 368-7778
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
Found on the OIG exclusion list (NPI match).
Nearby
Orthopedic Surgeons in Lodi, CA. 9 with this primary taxonomy in the public file.
Other NPIs in Lodi, CA. 1,310 records in the public file.
Public data from NPPES and CMS. Not a credentialing determination.
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