| Wilde Desert Family Medicine | |
|
302 El Camino Real Bldg 11 Sierra Vista AZ 85635-2860 | |
| (520) 255-5475 | |
| (855) 801-7998 |
| Full Name | Wilde Desert Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 302 El Camino Real Bldg 11, Sierra Vista, Arizona |
| Authorized Official Name and Position | Jeffrey Virgil Wilde (PHYSICIAN/OWNER) |
| Authorized Official Contact | 5202555475 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilde Desert Family Medicine 302 El Camino Real Bldg 11 Sierra Vista AZ 85635-2860 Ph: (520) 255-5475 | Wilde Desert Family Medicine 302 El Camino Real Bldg 11 Sierra Vista AZ 85635-2860 Ph: (520) 255-5475 |
| NPI Number | 1518515683 |
|---|---|
| Provider Enumeration Date | 08/30/2019 |
| Last Update Date | 09/30/2024 |
| Medicare PECOS PAC ID | 6901138049 |
|---|---|
| Medicare Enrollment ID | O20191023000751 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518515683 | NPI | - | NPPES |
| 552797 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Jeffrey V Wilde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073703310 PECOS PAC ID: 7113084302 Enrollment ID: I20110706000226 |
| Provider Name | James D Rowley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053806042 PECOS PAC ID: 8426306127 Enrollment ID: I20180810002188 |
| Provider Name | Nicole L Williams |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1013498328 PECOS PAC ID: 7618940735 Enrollment ID: I20181024003393 |
| Provider Name | Natalie V Pratt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861076648 PECOS PAC ID: 0042682320 Enrollment ID: I20230215000268 |
| Provider Name | Brandon Michael Trujillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770167553 PECOS PAC ID: 6608248836 Enrollment ID: I20230215002682 |
| Provider Name | Micheal A Kaiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053037812 PECOS PAC ID: 0446628267 Enrollment ID: I20230222001556 |
| Provider Name | Adam Kemp Crandell |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1194393868 PECOS PAC ID: 0345603767 Enrollment ID: I20240222001230 |
| Provider Name | Chelsey Ruiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952180259 PECOS PAC ID: 3072950799 Enrollment ID: I20240318001315 |
Lucy Burciaga Md Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 75 Colonia De Salud, Ste 200b, Sierra Vista, AZ 85635 Phone: 502-459-5959 | |
Sierra Vista Regional Health Center Medical Group Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5750 E Highway 90, Suite 200, Sierra Vista, AZ 85635 Phone: 520-263-3979 Fax: 520-263-3977 | |
Transmed Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1100 Joshua Tree Dr, Sierra Vista, AZ 85635 Phone: 520-439-4340 Fax: 520-458-0798 | |
Sierra Gastroenterology, Pllc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4990 E Mediterranean Dr, Suite A, Sierra Vista, AZ 85635 Phone: 520-458-5890 Fax: 520-458-4439 | |
Cchci Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 77 Calle Portal Ste A140, Sierra Vista, AZ 85635 Phone: 520-364-1429 | |
Valley Vista Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 157 N Coronado Dr, #c, Sierra Vista, AZ 85635 Phone: 520-458-0993 Fax: 520-458-4402 | |
Lenzner Medical Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 286 S Lenzner Avenue, Sierra Vista, AZ 85635 Phone: 520-452-0388 Fax: 520-452-0379 |