Individual
DR. JAMES GUY WYMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2001 5TH ST, SUITE 49, SILVIS, IL 61282-2903
(309) 792-2020
(309) 792-4753
Mailing address
777 TANGLEFOOT LN, BETTENDORF, IA 52722-1650
(563) 323-2020
(563) 328-5694
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036-081788
IL
207W00000X
Ophthalmology Physician
Primary
21468
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053918
—
IA
01
—
26568
IA GROUP MEDICARE
IA
01
—
790730
IL GROUP MEDICARE
IL
Enumeration date
12/28/2005
Last updated
09/17/2014
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