Wilson, Brent C

Wilson, Brent C is an individual health care provider with primary practice located at 4300 W Memorial Rd , Oklahoma City OK 73120-8304. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Wilson, Brent C can be contacted via phone (405) 752-3715.

Contact Information

Primary practice address
4300 W Memorial Rd Oklahoma City OK 73120-8304
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 17280 Oklahoma

Profile Details

NPI number 1760440879
LBN Legal business name Wilson, Brent C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated May 21st, 2014 - about 10 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 1760440879 NPPES
Oklahoma MEDICAID 100213520B

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