Wilson, Dexter E.

Wilson, Dexter E. is an individual health care provider with primary practice located at 918 Decathlon Dr , Waterloo IA 50701-3441. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wilson, Dexter E. can be contacted via phone (319) 236-2020.

Contact Information

Primary practice address
918 Decathlon Dr Waterloo IA 50701-3441
Phone: (319) 236-2020
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1657 Iowa

Profile Details

NPI number 1902890858
LBN Legal business name Wilson, Dexter E.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated Mar 13th, 2008 - about 17 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 1902890858 NPPES
Iowa MEDICAID 6146811

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