| Doctor Name: | BRIAN KEITH WISE |
| NPI Number: | 1043211683 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 41287 |
| Business Practice Address: | 7853 E Arapahoe Ct #3550 Centennial, CO - 801121359 |
| Business Phone Number: | 8776674366 |
| Business Fax Number: | 8776769763 |
| Mailing Address: | 7853 E Arapahoe Ct, #3550 CENTENNIAL |
| State: | CO |
| Postal Code: | 801121359 |
| Phone Number: | 8776674366 |
| Fax Number: | 8776769763 |
| NPI Enumeration Date: | 08/04/2005 |
| NPI Last Update Date: | 07/19/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2084P0804X |
| License Number: | 41287 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Psychiatry & Neurology |
| Taxonomy Specialization: | Child & Adolescent Psychiatry |
| Taxonomy Definition: | Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |