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NPI Code Detail

MEDICARE: ROGER D WILT M.D.

MEDICARE: ROGER D WILT 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
1207Q00000XFamily Medicine Physician35-06-0517OH

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 : 1801873013
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROGER D WILT M.D.
Provider Business Mailing Address
First Line : 3578 FISHINGER BLVD
Second Line :
City : HILLIARD
State : OH
Zip : 43026-7503
Country : US
Telephone Number : 614-457-4806
Fax Number : 614-457-0269
Provider Business Practice Location Address
First Line : 3311 TREMONT RD
Second Line : SUITE 101
City : COLUMBUS
State : OH
Zip : 43221-2008
Country : US
Telephone Number : 614-457-4806
Fax Number : 614-457-0269
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/29/2005
Last Update Date : 04/06/2013

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Directions to “ ROGER D WILT M.D.” Practice Location

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