Organization
KUTTAWA CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA WILDER MD (MEMBER)
(270) 853-8685
Entity
Organization
Contact information
Practice address
91 CEDAR STREET, KUTTAWA, KY 42055
(270) 853-8685
Mailing address
PO BOX 370, KUTTAWA, KY 42055-0370
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
3009151
KY
Other
Enumeration date
05/02/2014
Last updated
09/30/2020
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