Wilson, Gary L

Wilson, Gary L is an individual health care provider with primary practice located at 5500 E Kellogg Dr Department Of Radiology, Wichita KS 67218-1607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Wilson, Gary L can be contacted via phone (970) 250-2891.

Contact Information

Primary practice address
5500 E Kellogg Dr Department Of Radiology Wichita KS 67218-1607
Phone: (970) 250-2891
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X G-1584 Texas

Profile Details

NPI number 1174584551
LBN Legal business name Wilson, Gary L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated May 21st, 2013 - about 11 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 1174584551 NPPES
Kansas MEDICAID 100384790A

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