Individual
JONATHAN W WILDING
Active
Individual
JONATHAN W WILDING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27444
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000050941
ANTHEM / NCMA
—
01
—
000023035A
HUMANA / NCMA
—
01
—
008890
SIHO / NCMA
—
01
—
1055818
PASSPORT / NCMA
—
01
—
110161205
MEDICARE RAILROAD
KY
01
—
1198266
CHA / NCMA
—
01
—
2433815000
PASSPORT ADVANTAGE / NCMA
—
05
—
64274442
—
KY
01
—
7107709003
CIGNA / NCMA
—
Enumeration date
04/26/2006
Last updated
04/26/2023
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