MEDICARE: J SCOTT WILCHER M.D. INC

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
1	2086S0129X	Vascular Surgery Physician	35-061598	OH
2	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	35-061598	OH
3	208600000X	Surgery Physician	35-061598	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1730358169
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	J SCOTT WILCHER M.D. INC

Provider Business Mailing Address
First Line	:	7111 N MAIN ST
Second Line	:	STE 60
City	:	DAYTON
State	:	OH
Zip	:	45415-2558
Country	:	US
Telephone Number	:	937-276-3445
Fax Number	:	937-276-2855

Provider Business Practice Location Address
First Line	:	7111 N MAIN ST
Second Line	:	STE 60
City	:	DAYTON
State	:	OH
Zip	:	45415-2558
Country	:	US
Telephone Number	:	937-276-3445
Fax Number	:	937-276-2855

Authorized Official
Title or Position	:	OWNER
Name	:	DR. J SCOTT WILCHER
Credential	:	M.D.
Telephone Number	:	937-276-3445

Provider Enumeration Date	:	02/29/2008
Last Update Date	:	06/20/2011

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