Individual
JAMES W WILDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
331 S 3RD ST, LA CRESCENT, MN 55947-1328
(507) 895-6610
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20177
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30251700
—
WI
Enumeration date
06/10/2005
Last updated
07/12/2010
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