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Individual

DR. JOHN W. WYLLIE III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1000 N OAK AVE, MARSHFIELD, WI 54449-5702
(715) 387-5511
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
(304) 517-1404

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
23086
WV
207Y00000X
Otolaryngology Physician
35084546
OH
207Y00000X
Otolaryngology Physician
36803
KY
207Y00000X
Otolaryngology Physician
Primary
3816
WI
207Y00000X
Otolaryngology Physician
73267
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810011846
WV
05
L2496384
OH
Enumeration date
11/14/2005
Last updated
02/16/2024
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