Individual
JAMES DEREK WYLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
270960
MA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
55564
CT
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
8438015-1205
UT
Other
Enumeration date
03/30/2011
Last updated
09/25/2018
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