Wilson, Gary G
Wilson, Gary G is an individual health care provider with primary practice located at 1009 Novus Dr Ste 2 , Johnson City TN 37604-8237. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Wilson, Gary G can be contacted via phone (423) 283-0776.Contact Information
Primary practice address
1009 Novus Dr Ste 2
Johnson City TN 37604-8237
Phone: (423) 283-0776
Fax: (423) 968-5697
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | MD0000025656 | Tennessee |
Profile Details
| NPI number | 1679573505 |
|---|---|
| LBN Legal business name | Wilson, Gary G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2005 |
| Last updated | Jul 27th, 2021 - about 3 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 | 1679573505 | NPPES |
| Tennessee | MEDICAID | 3083961 |
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