PAUL MICHAEL WILDE

FORT LEAVENWORTH, KS
NPI1558361535
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: GA  1002775 NCCPA)
Enumeration Date2005-07-29
Last Update Date2007-07-08
Business Address
-- PAUL MICHAEL WILDE PA-C, Sc.D.
550 POPE AVE
FORT LEAVENWORTH, KS 66027-2332
Phone number: 913-684-6198
Mailing Address
-- PAUL MICHAEL WILDE PA-C, Sc.D.
5034 MUND RD
SHAWNEE, KS 66218-9147
Phone number: 913-422-8477
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