NPI 1245499003 · live from the CMS NPI Registry
Wendell Hayden Wilmoth, M.D.
Radiology, Diagnostic Radiology in Kodiak, AK. National Provider Identifier 1245499003, active.
NPI record
| NPI | 1245499003 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Radiology, Diagnostic Radiology 2085R0202X |
| Practice location | 1915 E Rezanof Dr, Kodiak, AK 99615 |
| Practice phone | 907-486-9581 |
| Mailing address | Po Box 10107, Knoxville, TN 37939 |
| Enumerated | June 6, 2008 |
| Last updated | December 9, 2025 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Radiology, Diagnostic Radiology | 2085R0202X | 75934 (TN) |
| Radiology, Diagnostic Radiology primary | 2085R0202X | 7852 (AK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.