| Doctor Name: | GREGORY LEE WERNER |
| NPI Number: | 1003297581 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A.-C |
| License Number: | 3532 - 23 |
| Business Practice Address: | 143 S Gibson St Medford, WI - 544511622 |
| Business Phone Number: | 7157482121 |
| Business Fax Number: | |
| Mailing Address: | W6435 Cedar St, MEDFORD |
| State: | WI |
| Postal Code: | 544518853 |
| Phone Number: | 7159652181 |
| Fax Number: | |
| NPI Enumeration Date: | 06/10/2015 |
| NPI Last Update Date: | 06/10/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 3532 - 23 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |