Provider Demographics
NPI:1104494673
Name:WHEAT, EMILY CAROLINE (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:CAROLINE
Last Name:WHEAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:CAROLINE
Other - Last Name:KROEGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1027
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:MO
Mailing Address - Zip Code:65102-1027
Mailing Address - Country:US
Mailing Address - Phone:573-681-3767
Mailing Address - Fax:573-681-3593
Practice Address - Street 1:2511 W EDGEWOOD DR STE G
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:MO
Practice Address - Zip Code:65109-5869
Practice Address - Country:US
Practice Address - Phone:573-761-0458
Practice Address - Fax:573-761-6957
Is Sole Proprietor?:No
Enumeration Date:2021-06-11
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAR-12122207Q00000X
MO2023047878207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine