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Organization
JEFFREY WILDE MD PLLC
Active
Organization
JEFFREY WILDE MD PLLC
Active
Other names
Wilde Desert Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY VIRGIL WILDE MD (PHYSICIAN/OWNER)
(520) 255-5475
Entity
Organization
Contact information
Practice address
302 EL CAMINO REAL BLDG 11, SIERRA VISTA, AZ 85635-2860
(520) 255-5475
(855) 801-7998
Mailing address
302 EL CAMINO REAL BLDG 11, SIERRA VISTA, AZ 85635-2860
(520) 255-5475
(855) 801-7998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
552797
—
AZ
Enumeration date
08/30/2019
Last updated
03/07/2025
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