Individual
DR. ELIJAH WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
285 BIELBY RD, LAWRENCEBURG, IN 47025-1055
(812) 537-1302
Mailing address
PO BOX 636256, CENTRAL CREDENTIALING ML 806, CINCINNATI, OH 45263-6256
(513) 585-5508
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
02006180A
IN
2084P0800X
Psychiatry Physician
04444
KY
2084P0800X
Psychiatry Physician
34012700
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300047738
—
IN
05
—
7100473760
—
KY
Enumeration date
06/15/2012
Last updated
07/03/2025
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