Individual
DEBRA L. WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
91 CEDAR ST, KUTTAWA, KY 42055-6287
(270) 388-7380
(270) 388-7364
Mailing address
PO BOX 370, 91 CEDAR STREET, KUTTAWA, KY 42055-0370
(270) 388-7380
(270) 388-7364
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
28168
KY
207Q00000X
Family Medicine Physician
Primary
28168
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64281686
—
KY
Enumeration date
10/24/2005
Last updated
11/30/2018
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