Wandler, Kevin Richard
Wandler, Kevin Richard is an sole proprietor health care provider with primary practice located at 888 S Hillhurst Rd , Ridgefield WA 98642-9063. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Wandler, Kevin Richard can be contacted via phone (754) 300-3120.Contact Information
Primary practice address
888 S Hillhurst Rd
Ridgefield WA 98642-9063
Phone: (754) 300-3120
Fax: (954) 306-8977
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | DR.0055465 | Colorado |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | 130525 | Ohio |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | 2022048625 | Missouri |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 14421 | Arizona |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | ME110716 | Florida |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | MD60562814 | Washington |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | 01092373A | Indiana |
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | 25MA10809300 | New Jersey |
Profile Details
| NPI number | 1205956265 |
|---|---|
| LBN Legal business name | Wandler, Kevin Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 30th, 2007 |
| Last updated | Apr 3rd, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205956265 | NPPES |
| Florida | MEDICAID | 004007100 |
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