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NPI Code Detail

MEDICARE: THOMAS WILLIAM WILDER M.D.

MEDICARE: THOMAS WILLIAM WILDER M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician04-28646KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518924653
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS WILLIAM WILDER M.D.
Provider Business Mailing Address
First Line : 8919 PARALLEL PKWY STE 270
Second Line :
City : KANSAS CITY
State : KS
Zip : 66112-1655
Country : US
Telephone Number : 913-334-6800
Fax Number : 913-334-0875
Provider Business Practice Location Address
First Line : 8919 PARALLEL PKWY STE 270
Second Line :
City : KANSAS CITY
State : KS
Zip : 66112-1655
Country : US
Telephone Number : 913-334-6800
Fax Number : 913-334-0875
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 12/03/2021

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Directions to “ THOMAS WILLIAM WILDER M.D.” Practice Location

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