Wilson, Gary A
Wilson, Gary A is an individual health care provider with primary practice located at 311 N Clyde Morris Blvd , Daytona Beach FL 32114-2781. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Wilson, Gary A can be contacted via phone (386) 947-4650.Contact Information
Primary practice address
311 N Clyde Morris Blvd
Daytona Beach FL 32114-2781
Phone: (386) 947-4650
Fax: (386) 947-4690
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 34858 | Iowa |
Profile Details
| NPI number | 1215933056 |
|---|---|
| LBN Legal business name | Wilson, Gary A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 27th, 2005 |
| Last updated | Jul 10th, 2009 - about 15 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 | 1215933056 | NPPES |
| Iowa | MEDICAID | 0276915 |
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