ROBERT JAY WILDMAN PA-C NPI 1033262910

NPI Information

NPI: 1033262910
Provider Name: ROBERT JAY WILDMAN, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
2400 GREATSTONE PT
LEXINGTON, KY
ZIP 40504
Phone: (859) 257-9800
Get Directions

Robert Jay Wildman, PA-C is a medical physician assistant in Lexington, KY. Robert Jay Wildman, PA-C NPI is 1033262910. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2400 GREATSTONE PT
LEXINGTON, KY
ZIP 40504-274
Phone: (859) 257-9800

The enumeration date for this NPI number is 1/22/2007 and was last updated on 4/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA038	KENTUCKY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	P26723	MEDICARE UPIN
2	0621207	MEDICARE ID-TYPE UNSPECIFIED
3	95001236	MEDICAID	KENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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