Dr JODY LYNN WISEMAN MD is a female medical professional, specializing in Family Medicine. She graduated in 1998 from Indiana University School Of Medicine.
BEACON MEDICAL GROUP INC
900 I ST
LA PORTE
IN
463505533
Tel: 2193241700
| Npi | 1215912415 |
| Pac Id | 7416954458 |
| Professional Enrollment Id | I20061103000353 |
| Last Name | WISEMAN |
| First Name | JODY |
| Middle Name | LYNN |
| Suffix | |
| Gender | F |
| Credential | MD |
| Medical School Name | INDIANA UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1998 |
| Primary Specialty | FAMILY MEDICINE |
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| Organization Legal Name | BEACON MEDICAL GROUP INC |
| Group Practice Pac Id | 1254243306 |
| Number Of Group Practice Members | 328 |
| Line 1 Street Address | 900 I ST |
| Line 2 Street Address | |
| Marker Of Address Line 2 Suppression | |
| City | LA PORTE |
| State | IN |
| Zip Code | 463505533 |
| Phone Number | 2193241700 |
| Hospital Affiliation Ccn 1 | 150058 |
| Hospital Affiliation Lbn 1 | MEMORIAL HOSPITAL OF SOUTH BEND |
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| Professional Accepts Medicare Assignment | Y |
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