Wilde, James W

Wilde, James W is an individual health care provider with primary practice located at 331 S 3Rd St , La Crescent MN 55947-1328. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wilde, James W can be contacted via phone (507) 895-6610.

Contact Information

Primary practice address
331 S 3Rd St La Crescent MN 55947-1328
Phone: (507) 895-6610
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 20177 Wisconsin

Profile Details

NPI number 1508860255
LBN Legal business name Wilde, James W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 10th, 2005
Last updated Jul 12th, 2010 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508860255 NPPES
Wisconsin MEDICAID 30251700

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