TIMOTHY BLAKE WILDER IDMT
NPI 1184858045
Military Health Care Provider - Independent Duty Medical Technicians in Scott Afb, IL

Active since May 07, 2009
310 W LOSEY ST, SCOTT AFB, IL 62225(618) 256-8970 Get Directions Write a Review

NPPES record last updated: May 7, 2009. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Timothy Blake Wilder Idmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY BLAKE WILDER IDMT (NPI 1184858045) is an individual independent duty medical technicians provider in Scott Afb, Illinois and active in the NPI registry since May 2009.

NPPES Registry Identity

NPI1184858045
Entity TypeIndividualMale
Primary Taxonomy1710I1003X
Provider Legal NameTIMOTHY BLAKE WILDERCredential: IDMT
Location Address310 W LOSEY STScott Afb, IL 62225-5250
Mailing Address68 Circle DrFairview Heights, IL 62208-3303 · (618) 394-3552
Sole ProprietorYes
Enumeration DateMay 7, 2009
NPI 1184858045 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code1710I1003X
Definition
An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
310 W LOSEY ST, Scott Afb, IL 62225

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (Oral and Maxillofacial Surgery)
310 W LOSEY ST
SCOTT AFB, IL 62225
Physical Therapist
310 W LOSEY ST
SCOTT AFB, IL 62225
Pharmacist
310 W LOSEY ST
SCOTT AFB, IL 62225
Family Medicine
310 W LOSEY ST
SCOTT AFB, IL 62225
Registered Nurse
310 W LOSEY ST
SCOTT AIR FORCE BASE, IL 62225
Dentist (Prosthodontics)
310 W LOSEY ST
SCOTT AFB, IL 62225
Obstetrics & Gynecology
310 W LOSEY ST
SCOTT AFB, IL 62225
Social Worker (Clinical)
310 W LOSEY ST
SCOTT AIR FORCE BASE, IL 62225

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Wilder's NPI number?

The NPI number for Timothy Wilder is 1184858045. It was assigned to this individual provider in the NPPES registry on May 7, 2009.

Where is Timothy Wilder located?

Timothy Wilder practices at 310 W Losey St, Scott Afb, IL 62225. The listed phone number is (618) 256-8970.

What is Timothy Wilder's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Medical Technicians, with taxonomy code 1710I1003X.

When was this NPI record last updated?

The NPPES record for Timothy Wilder was last updated on May 7, 2009. NPI Profile syncs with the weekly NPPES data releases published by CMS.