Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Mark Edwin Wisner, PHD, PA-C

Individual provider Medical Physician Assistant · NPI 1598771586

Dr. Mark Edwin Wisner, PHD, PA-C is a Medical Physician Assistant in Leavenworth, Kansas. Licensed in Kansas. Registered with an NPI since 2006.

Licensed in
KS
In the registry since
2006
Specialties on file
2
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4101 S 4th St Vamc Rm A541
Leavenworth, KS 66048-5014
Phone: (913) 758-5416
Fax: (913) 758-4219
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA 15-000385 (KS)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA-15-000385 (KS)

Record details

NPI number1598771586
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD , PA-C
Sole proprietorNo
NPI enumeratedJuly 31, 2006
Last updated in NPPESSeptember 23, 2010
Mailing address4101 S 4th St, Vamc Rm. A541, Leavenworth, KS 66048-5014

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