IndividualActive
Timothy Wilder, IDMT
NPI 1184858045 · Independent Duty Medical Technicians · Scott Afb, IL
Provider details
- NPI number
- 1184858045
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Credential
- IDMT
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Practice location
310 W Losey St
Scott Afb, IL 62225-5250
Phone: (618) 256-8970
Approximate (ZIP-level) locationGet directions
Mailing address
68 Circle Dr
Fairview Heights, IL 62208-3303
Registry dates
- Enumerated
- 2009-05-07
- Last updated
- 2009-05-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.