Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TIMOTHY BLAKE WILDER, IDMT
Active Sole ProprietorTIMOTHY BLAKE WILDER, IDMT is a Independent Duty Medical Technician healthcare provider located in SCOTT AFB, Illinois. NPI 1184858045 is currently active in the NPPES registry. Verify at CMS.
Independent Duty Medical Technician · SCOTT AFB, IL
Registration Details
- NPI Number
- 1184858045
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 7, 2009 (17.230007415846 yrs)
- Last Updated
- May 7, 2009
- Sole Proprietor
- Yes
Practice Information
- Address
-
310 W LOSEY STSCOTT AFB, IL, 622255250Browse IL providers · Browse ZIP 62225
- Phone
- 6182568970
- Primary Specialty
-
Independent Duty Medical Technician
1710I1003X
Other Independent Duty Medical Technician Providers in SCOTT AFB, IL
| Name | Credential | NPI |
|---|---|---|
| RAYMOND J FLAIZ | IDMT | 1639313240 |
| RYAN MICHAEL DAVIS | IDMT | 1922232909 |
| ANDREW ZAVALA | IDMT | 1164656088 |
| MR. CLYDE NOBLES JR. | IDMT | 1255565149 |
| MR. PATRICK CHRISTOPHER KORTHUIS | IDMT | 1770818056 |
| MELISSA DAWN GOFF | IDMT | 1487998746 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.