Provider Demographics
NPI:1043650518
Name:WYLER, JOSHUA HAROLD (PA-C)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:HAROLD
Last Name:WYLER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8350 E RAINTREE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2692
Mailing Address - Country:US
Mailing Address - Phone:480-508-0882
Mailing Address - Fax:
Practice Address - Street 1:8350 E RAINTREE DR STE 130
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2692
Practice Address - Country:US
Practice Address - Phone:480-508-0882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-28
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110-004291363A00000X
AZ5671363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant