Organization
JEUTI B. WYLDE, MD PSC
Active
Organization
JEUTI B. WYLDE, MD PSC
Active
Other names
Jeffersonville Psychiatric Associates
Organization subpart
No
Provider details
NPI number
Authorized official
JEUTI B. WYLDE MD (OWNER/OPERATOR)
(812) 282-2036
Entity
Organization
Contact information
Practice address
1114 E. 10TH ST., JEFFERSONVILLE, IN 47130-4227
(812) 282-2036
(812) 282-2277
Mailing address
PO BOX 128, OTISCO, IN 47163-0128
(812) 282-2036
(812) 282-2277
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01041261A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100362930
—
IN
Enumeration date
11/16/2008
Last updated
05/03/2010
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