Wylde, Jeuti B

Wylde, Jeuti B is an individual health care provider with primary practice located at 1035 Wall St Suite 102, Jeffersonville IN 47130-3612. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Wylde, Jeuti B can be contacted via phone (812) 282-2036.

Contact Information

Primary practice address
1035 Wall St Suite 102 Jeffersonville IN 47130-3612
Fax: (812) 282-2227
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 01041261 Indiana

Profile Details

NPI number 1740285741
LBN Legal business name Wylde, Jeuti B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Jan 4th, 2016 - about 8 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 1740285741 NPPES
Indiana MEDICAID 100362930

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