Individual
CAROL JEAN WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
70 BOWER DRIVE, MEDFORD, OR 97501
(541) 734-3650
(206) 368-6101
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 732-3650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00048866
WA
207Q00000X
Family Medicine Physician
Primary
MD185352
OR
207QS0010X
Sports Medicine (Family Medicine) Physician
00048866
WA
207QS0010X
Sports Medicine (Family Medicine) Physician
10509
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49963303
—
HI
Enumeration date
10/05/2006
Last updated
03/25/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us