Provider Demographics
NPI:1730358169
Name:J SCOTT WILCHER M.D. INC
Entity type:Organization
Organization Name:J SCOTT WILCHER M.D. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WILCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-276-3445
Mailing Address - Street 1:7111 N MAIN ST
Mailing Address - Street 2:STE 60
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2558
Mailing Address - Country:US
Mailing Address - Phone:937-276-3445
Mailing Address - Fax:937-276-2855
Practice Address - Street 1:7111 N MAIN ST
Practice Address - Street 2:STE 60
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2558
Practice Address - Country:US
Practice Address - Phone:937-276-3445
Practice Address - Fax:937-276-2855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0615982086S0129X, 208G00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2879130Medicaid
OH0711862Medicare PIN