Keith Thomas Wiethaupt
Keith Thomas Wiethaupt is a Surgical Physician Assistant in O Fallon, Missouri. Practices as a sole proprietor. Licensed in Missouri.
- Licensed in
- MO
- In the registry since
- 2026
Practice location Address checks out
7827 Town Square Ave Ste 104O Fallon, MO 63368-7199
Phone: (636) 734-0386
Fax: (636) 352-4173
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Surgical Physician Assistant (primary) | Taxonomy 363AS0400X · Licence 147974 (MO) |
|---|
Record details
| NPI number | 1801718788 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 29, 2026 |
| Last updated in NPPES | July 29, 2026 |
| Certification date | July 29, 2026 |
| Mailing address | 7827 Town Square Ave Ste 104, O Fallon, MO 63368-7199 |
Other providers in O Fallon
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James W Harris, CSFA
7827 Town Square Ave Ste 104, O Fallon, MO 63368-7199 · (636) 734-0386
-
Julie Hummel
7827 Town Square Ave Ste 104, O Fallon, MO 63368-7199 · (636) 734-0386
-
Miss. Michelle L Powell
7827 Town Square Ave Ste 104, O Fallon, MO 63368-6704 · (636) 734-0386
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Surgical Supply Solutions
2425 Sansonnet Ln, O Fallon, MO 63368-3597 · (501) 658-6186