Wilson, Gregory L
Wilson, Gregory L is an individual health care provider with primary practice located at 9709 E 79Th St , Tulsa OK 74133-4566. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM, Allopathic & Osteopathic Physicians / Neurological Surgery. Allopathic & Osteopathic Physicians / Neurological Surgery is his primary health care specialty. Wilson, Gregory L can be contacted via phone (918) 994-4000.Contact Information
Primary practice address
9709 E 79Th St
Tulsa OK 74133-4566
Phone: (918) 994-4000
Fax: (918) 994-4090
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM | 204D00000X | 2754 | Oklahoma |
Allopathic & Osteopathic Physicians / Neurological Surgery | 207T00000X | 2754 | Oklahoma |
Profile Details
NPI number | 1619030996 |
---|---|
LBN Legal business name | Wilson, Gregory L |
Credentials | Doctor of Osteopathy (DO) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Dec 18th, 2006 |
Last updated | Aug 22nd, 2022 - about 2 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 | 1619030996 | NPPES |
Oklahoma | MEDICAID | 100125210A |
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