Individual
DR. JEFFREY VIRGIL WILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
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
44157
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
613078
—
AZ
Enumeration date
08/01/2007
Last updated
03/18/2022
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