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Individual

DR. JEUTI B WYLDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1035 WALL ST, SUITE 102, JEFFERSONVILLE, IN 47130-3612
(812) 282-2036
(812) 282-2227
Mailing address
PO BOX 890631, CHARLOTTE, NC 28289-0631
(812) 542-4921
(812) 949-5966

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01041261
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100362930
IN
Enumeration date
06/16/2005
Last updated
01/04/2016
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