NPI 1124193503

Theodore R Wissink, MD

Practitioner Family Medicine Physician South Burlington, VT

Practice location

Address: 118 Tilley Dr STE 201, South Burlington, VT 05403-4450
Phone: (802) 847-5550
Fax: (802) 847-3646
Mailing address: 111 Colchester Ave, Burlington, VT 05401-1473

Registered specialties (2)

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 042.0019084 (VT)

Other Family Medicine providers in Vermont →

Family Medicine Physician

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 017817 (ME)

Registry record

NPI: 1124193503
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Nov 2006
Record last updated: 22 Dec 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.