Wilder, Thearon Paul
Wilder, Thearon Paul is an individual health care provider with primary practice located at 1997 Barrett Ct , Henderson KY 42420-2667. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilder, Thearon Paul can be contacted via phone (270) 827-8662.Contact Information
Primary practice address
1997 Barrett Ct
Henderson KY 42420-2667
Phone: (270) 827-8662
Fax: (270) 826-8220
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 15950 | Kentucky |
Profile Details
| NPI number | 1588661458 |
|---|---|
| LBN Legal business name | Wilder, Thearon Paul |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 6th, 2005 |
| Last updated | Mar 11th, 2013 - about 13 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 | 1588661458 | NPPES |
| Kentucky | MEDICAID | 64159502 |
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