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JAMES MARCUS WILDER PA-C

Medical >> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1942298609

Individual Registrant:
 JAMES MARCUS WILDER PA-C
Gender: M
Not Sole Proprietor

Location and contact information for practice:
160 CENTRAL AVE  TRION, GA 30753-1125 US
Tel: 706-734-7302  Fax: 706-734-7356

Contact information for business:
PO BOX 406746  ATLANTA, GA 30384-6746 US
Tel: 706-734-7302  Fax: 706-734-7356

Registration Information:
NPI: 1942298609
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363AM0700XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Medical
NC101390

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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