Individual
DR. TODD WICK WYLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 W 8TH ST, UFJP EMERGENCY MEDICINE, JACKSONVILLE, FL 32209-6511
(904) 244-5044
(904) 244-4508
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008
(904) 244-3660
(904) 244-3425
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME83747
FL
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
ME83747
FL
Other
Enumeration date
01/28/2006
Last updated
08/24/2007
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