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:
Health care specialties
Specialty | Code | License # | 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1174584551 | NPPES |
Kansas | MEDICAID | 100384790A |
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