DR. KATHLYN VALLEAU WILDE


Address: 620 John Paul Jones Cir Dept Of, Portsmouth, VA 23708-2111
Phone: 7579537716

DR. KATHLYN VALLEAU WILDE (NPI# 1164683967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164683967
Entity Type Individual
Full Name DR. KATHLYN VALLEAU WILDE
Credential M.D.
Practice Address 620 John Paul Jones Cir Dept Of
Portsmouth
VA 23708-2111
Mailing Address 620 John Paul Jones Cir Dept of Pediatrics
Portsmouth
VA 23708-2111
Practice Telephone 7579537716
Practice Fax Number 7579530858
Mailing Telephone (301) 337-5055
Mailing Fax Number 7579530858
Enumeration Date 2008-06-24
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208000000X Pediatrics 0101261046 VA Allopathic & Osteopathic Physicians
N 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Provider Secondary Practice Location

Address Telephone Number Fax Number
8901 Wisconsin Ave, Bethesda, MD 208890001 4344098249

Office Location

Street Address 620 JOHN PAUL JONES CIR DEPT OF
City PORTSMOUTH
State VA
Zip Code 23708-2111

Providers in the same location

NPI Name Taxonomy Address Enumeration
1982187696 Jennifer Lynn Biehl Mayer Dietitian, Registered 620 John Paul Jones Cir Dept Of, Portsmouth, VA 23708-2111 2018-09-09
1295197671 Katheryn Ryan Student in an Organized Health Care Education/Training Program 620 John Paul Jones Cir Dept Of, Portsmouth, VA 23708-2111 2016-03-24
1205136496 Ines Stromberg Urology 620 John Paul Jones Cir Dept Of, Portsmouth, VA 23708-2111 2010-10-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932724754 William Dowling Student in an Organized Health Care Education/Training Program 260 John Paul Jones Circle, Fpo, AA 23708 2020-06-09
1760003156 Kylie Miller Student in an Organized Health Care Education/Training Program 600 John Paul Jones Circle, Portsmouth, VA 23708 2020-04-27
1750900304 Jonathan David Hickman Student in an Organized Health Care Education/Training Program Nmcp 620 John Paul Jones Cir., Bldg 3, Portsmouth, VA 23708 2020-04-14
1447716550 Nathan Le Holterman Student in an Organized Health Care Education/Training Program Navy Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708 2019-02-13
1467930545 Jonathan Volland Dentist Naval Medical Center - 620 John Paul Jones Cr, Portsmouth, VA 23708 2018-08-01
1629570171 Brendan James O'shea Student in an Organized Health Care Education/Training Program 690 John Paul Jones Circle, Fpo, AA 23708 2018-03-01
1467909077 Patricia Hicks Smith Nurse Practitioner 620 John Paul Jones Blvd., Naval Medical Center Portsmouth, Portsmouth, VA 23708 2016-09-01
1790139392 Lauren Pitters Student in an Organized Health Care Education/Training Program 620 John Paul Jones Circle Drive, Naval Medical Center Portsmouth, Portsmouth, VA 23708 2016-04-20
1841683745 Karrie Anne Brondell Walker Student in an Organized Health Care Education/Training Program 620 John Paul Jones, Naval Medical Center Portsmouth, Portsmouth, VA 23708 2015-03-17
1962821967 Jody Manners Psychiatry & Neurology 620 John Paul Jones Cir # 2e, Portsmouth, VA 23708 2014-04-08
Find all providers in zip 23708

Taxonomy Information

Taxonomy Code 208000000X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics

Taxonomy Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio
- Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1134685050 Tidewater Pediatrics, P.C. Pediatrics 301 Goode Way Ste 203, Portsmouth, VA 23704-2266 2019-02-15
1437235421 Perla Jamias Soloria Pediatrics 3701 South St, Portsmouth, VA 23707-3121 2006-10-31
1265523310 Portsmouth Pediatrics Pediatrics 1985 E Main Rd, Portsmouth, RI 02871-1225 2006-09-27
1508884503 John R Radford Pediatrics 1611 27th St Ste 101, Portsmouth, OH 45662-6932 2006-07-17
1679529424 Kevin Hodges Pediatrics 200 Griffin Rd, Suite 15, Portsmouth, NH 03801-7145 2006-05-25
1225089196 Rick David Murphy Pediatrics 1405 11th St, Portsmouth, OH 45662 2006-05-15
1811956204 04gloria Villanueva De La Cruz Pediatrics 500 Rodman Ave, Portsmouth, VA 23707-3100 2006-03-22
1205800489 Lilliam I. Ortiz Pediatrics 23030 State Route 73, Portsmouth, OH 45663-8861 2006-02-15
1528039328 Caleb John Podraza Pediatrics Naval Medical Center Department of Pediatrics, 620 John Paul Jones Circle, Portsmouth, VA 23708 2006-01-30
1437129202 Olivia Y Alegre - Ipanag Pediatrics 446 Effingham St., Ste 302, Portsmouth, VA 23704-4818 2006-01-25
Find all providers in PORTSMOUTH

Competitor

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City PORTSMOUTH
Zip Code 23708

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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