Wilson, Gregory S

Wilson, Gregory S is an individual health care provider with primary practice located at 1525 W Frye Rd , Chandler AZ 85224-6178. He recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as his primary health care specialty. Wilson, Gregory S can be contacted via phone (480) 812-7000.

Contact Information

Primary practice address
1525 W Frye Rd Chandler AZ 85224-6178
Phone: (480) 812-7000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X

Profile Details

NPI number 1043345218
LBN Legal business name Wilson, Gregory S
Credentials SSP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2007
Last updated Jul 9th, 2007 - about 17 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 1043345218 NPPES
Arizona MEDICAID 952243

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