Individual
DR. WENDELL HAYDEN WILMOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1915 E REZANOF DR, KODIAK, AK 99615-6602
(907) 486-9581
Mailing address
PO BOX 10107, KNOXVILLE, TN 37939-0107
(865) 584-7376
(865) 540-3856
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
75934
TN
2085R0202X
Diagnostic Radiology Physician
Primary
7852
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1585319
—
AK
Enumeration date
06/06/2008
Last updated
12/09/2025
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