Individual
DR. CORIN Q WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
407 E CENTENNIAL DR, PITTSBURG, KS 66762-6505
(620) 231-5940
(620) 231-5948
Mailing address
407 E CENTENNIAL DR, PITTSBURG, KS 66762-6505
(620) 231-5940
(620) 231-5948
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
12-00315
KS
213ES0103X
Foot & Ankle Surgery Podiatrist
2000168834
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
114056
BLUE CROSS
KS
01
—
UMWA
0638544
KS
Enumeration date
11/15/2005
Last updated
10/22/2014
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