NPI 1629560917

Wildwood Physician Services, LLC

Organisation Emergency Medicine Physician Blacksburg, VA

Practice location

Address: 3700 S Main St, Blacksburg, VA 24060-7017
Phone: (540) 951-1111
Mailing address: 200 Corporate Blvd, Lafayette, LA 70508-3870

Authorised official

Name: Lisha C Falk
Title: Vp of Contracting
Phone: (337) 609-1221

Registered specialties (3)

Emergency Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207P00000X

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Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X

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Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363L00000X

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Registry record

NPI: 1629560917
Entity type: Organization
NPI issued: 1 Jun 2018
Record last updated: 23 Mar 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.