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Individual
DR. JAMES GUY WYMORE
Active
Individual
DR. JAMES GUY WYMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036-081788
IL
207W00000X
Ophthalmology Physician
Primary
21468
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053918
—
IA
01
—
26568
IA GROUP MEDICARE
IA
01
—
790730
IL GROUP MEDICARE
IL
Enumeration date
12/28/2005
Last updated
09/17/2014
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