Mark F Wildman in Columbia - Physician Assistant

Mark F Wildman - NPI 1922091560

Mark F Wildman is a Physician Assistant in Columbia, Missouri. Mark F Wildman practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Mark F Wildman is 1922091560. The last update date is 2008-07-30.

Mark F Wildman's current location address is 1 S Keene St, Columbia, Missouri. You can contact this provider via phone number 5734432402 and fax number 5734430574. The mailing address for Mark F Wildman is 1 S Keene St, Columbia, Missouri. To know further, please read the information below!

Provider Profile Detail

Provider Name Mark F Wildman
Address 1 S Keene St, Columbia, Missouri
Phone Number 5734432402
Fax Number 5734430574
Sole Proprietor N
Credentials PA-C

NPI Number Detail

NPI Number 1922091560
Provider Enumeration Date 2005-08-30
Last Updated Date 2008-07-30

Provider Mailing Address Detail

Address 1 S Keene St
City Columbia
State Missouri (MO)
Post Code 652017199
Phone Number 5734432402
Fax Number 5734430574

Provider's Primary Taxonomy Detail

Speciality Physician Assistant
Taxonomy 363A00000X
Licence No 105965
Definition:
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor

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FAQs about Mark F Wildman

Could you provide the complete physical address where Mark F Wildman is located?

The Mark F Wildman is situated at the following address: 1 S Keene St, Columbia, MO, 652017199.

Could you kindly provide the complete physical address where Mark F Wildman's facilities are geographically located?

The facilities of Mark F Wildman are physically situated at the following location: 1 S Keene St, Columbia, MO, 652017199.

What is Mark F Wildman's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?

The primary field of medical specialization for Mark F Wildman is Physician Assistant, and the taxonomy classification code that categorizes this area of expertise is 363A00000X.

On what date did Mark F Wildman receive its 1922091560 assignment from the Centers for Medicare & Medicaid Services?

The Mark F Wildman was assigned its 1922091560 on 2005-08-30, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.

When was the information related to Mark F Wildman most recently updated or refreshed?

The details pertaining to the Mark F Wildman, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-07-30.

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