Provider Demographics
NPI:1093722423
Name:WILTERS, JOHN HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HOWARD
Last Name:WILTERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2201 MURPHY AVE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1835
Mailing Address - Country:US
Mailing Address - Phone:615-329-4646
Mailing Address - Fax:615-321-4977
Practice Address - Street 1:2201 MURPHY AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1835
Practice Address - Country:US
Practice Address - Phone:615-329-4646
Practice Address - Fax:615-321-4977
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2011-10-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN0028209207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3718229Medicaid
TN3804250Medicare ID - Type UnspecifiedJOHN H WILTERS, MD
TN3718229Medicaid