Wilson, Basil Alexander

Wilson, Basil Alexander is an individual health care provider with primary practice located at 1801 Crystal Lake Dr , Lakeland FL 33801-5979. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Wilson, Basil Alexander can be contacted via phone (863) 937-8886.

Contact Information

Primary practice address
1801 Crystal Lake Dr Lakeland FL 33801-5979
Phone: (863) 937-8886
Fax: (863) 937-8892
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP 2068702 Florida

Profile Details

NPI number 1447259569
LBN Legal business name Wilson, Basil Alexander
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Oct 14th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447259569 NPPES
Florida MEDICAID 303424100
Florida Other 034712822
Florida Other ARNP 2068702

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