Wilson, Douglas J
Wilson, Douglas J is an individual health care provider with primary practice located at 400 W Green Meadows Dr Suite 108, Greenfield IN 46140-3204. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Wilson, Douglas J can be contacted via phone (317) 477-3937.Contact Information
Primary practice address
400 W Green Meadows Dr Suite 108
Greenfield IN 46140-3204
Phone: (317) 477-3937
Fax: (317) 477-3939
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 18002895A/B | Indiana |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 18002895A/B | Indiana |
Profile Details
| NPI number | 1235138876 |
|---|---|
| LBN Legal business name | Wilson, Douglas J |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 15th, 2005 |
| Last updated | Dec 13th, 2011 - about 13 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235138876 | NPPES |
| Indiana | Other | 000000176992 | BCBS |
| Indiana | Other | 410043699 | BCBS |
| Indiana | Other | JARTL | BCBS |
| Indiana | Other | IN2895 | BCBS |
| Indiana | MEDICAID | 200280210A | BCBS |
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