Wilder, Carol Jean

Wilder, Carol Jean is an individual health care provider with primary practice located at 70 Bower Drive , Medford OR 97501. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Wilder, Carol Jean can be contacted via phone (541) 734-3650.

Contact Information

Primary practice address
70 Bower Drive Medford OR 97501
Phone: (541) 734-3650
Fax: (206) 368-6101
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 00048866 Washington
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 10509 Hawaii
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X 00048866 Washington
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD185352 Oregon

Profile Details

NPI number 1801982749
LBN Legal business name Wilder, Carol Jean
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Mar 25th, 2021 - about 3 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 1801982749 NPPES
Hawaii MEDICAID 49963303

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