Thomas L Wilson M D Ltd

LBN: Thomas L Wilson M D Ltd
Thomas L Wilson M D Ltd is an health care organization with primary practice located at 814 W State , Jacksonville IL 62650. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as the primary health care specialty. Thomas L Wilson M D Ltd can be contacted via phone (217) 243-1865, or through Wilson, Charles Stott via phone (217) 243-1865.

Contact Information

Primary practice address
814 W State Jacksonville IL 62650
Phone: (217) 243-1865
Fax: (217) 243-6765
Website:
Map and Directions
Authorized official contact:
Name: Wilson, Charles Stott Doctor of Medicine (MD)
Phone: (217) 243-1865

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 060001084 Illinois

Profile Details

NPI number 1275597817
LBN Legal business name Thomas L Wilson M D Ltd
DBA Doing business as
Authorized official Wilson, Charles Stott Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 12th, 2006
Last updated Jun 1st, 2011 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275597817 NPPES
Illinois MEDICAID 036043460

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