Wild, Alan P K
Wild, Alan P K is an individual health care provider with primary practice located at 3660 Vista Ave Ste. 312, Saint Louis MO 63110. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Wild, Alan P K can be contacted via phone (314) 977-5110.Contact Information
Primary practice address
3660 Vista Ave Ste. 312
Saint Louis MO 63110
Phone: (314) 977-5110
Fax: (314) 977-5119
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | R9D17 | Missouri |
Profile Details
| NPI number | 1871582692 |
|---|---|
| LBN Legal business name | Wild, Alan P K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 14th, 2005 |
| Last updated | Nov 20th, 2009 - about 15 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 | 1871582692 | NPPES |
| Missouri | Other | 040004991 | RAILROAD MEDICARE |
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