Richard Edward Wild, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

022194 Issued in GA

Practice address

1275 Oak Grove Dr
Decatur, GA 30033-2737

Phone

(404) 315-6110

Fax

(404) 315-6074

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053412908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 OAK GROVE DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332737",
            "telephone_number": "404-315-6110",
            "fax_number": "404-315-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 OAK GROVE DR",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300332737",
            "telephone_number": "404-315-6110",
            "fax_number": "404-315-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "RICHARD",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "022194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wholeness Within LLC
• Titia Delores Widener-Williams, NP
• Daniel Kyle Wiesman
• Kayla Wiggins, RN
• William Wilcox
• Cometa Wilder, LCSW
• Albert Wildstein, MD
• Janice Marie Wiley, LCSW
• Stephanie Wiley
• Beth J Wilkening, P.A.-C

• Emergency Medicine Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.