Wilde, James A

Wilde, James A is an individual health care provider with primary practice located at 1120 15Th St , Augusta GA 30912-0004. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, which is considered as his primary health care specialty. Wilde, James A can be contacted via phone (706) 721-4951.

Contact Information

Primary practice address
1120 15Th St Augusta GA 30912-0004
Fax: (706) 721-7941
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 046011 Georgia

Profile Details

NPI number 1598876385
LBN Legal business name Wilde, James A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 31st, 2006
Last updated Feb 21st, 2014 - about 10 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 1598876385 NPPES
South Carolina MEDICAID G46011
South Carolina MEDICAID 000797574A

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