Wilder, Timothy Blake

Wilder, Timothy Blake is an sole proprietor health care provider with primary practice located at 310 W Losey St , Scott Afb IL 62225-5250. He recently has only one registered license in Other Service Providers / Independent Duty Medical Technicians, which is considered as his primary health care specialty. Wilder, Timothy Blake can be contacted via phone (618) 256-8970.

Contact Information

Primary practice address
310 W Losey St Scott Afb IL 62225-5250
Phone: (618) 256-8970
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Independent Duty Medical Technicians 1710I1003X

Profile Details

NPI number 1184858045
LBN Legal business name Wilder, Timothy Blake
Credentials IDMT
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 7th, 2009
Last updated May 7th, 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.

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