Individual
DR. DEREK L WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
11310 BEACH CHANNEL DR, ROCKAWAY PARK, NY 11694-2209
(718) 474-1234
(718) 945-5809
Mailing address
4000 POPLAR LEVEL RD, LOUISVILLE, KY 40213-1524
(502) 813-8923
(502) 451-8663
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1704DT
KY
Other
Enumeration date
02/27/2007
Last updated
01/29/2021
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