Wilson, Jeffrey K
Wilson, Jeffrey K is an individual health care provider with primary practice located at 5111 Clinton Dr , Kokomo IN 46902-7136. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilson, Jeffrey K can be contacted via phone (765) 457-8381.Contact Information
Primary practice address
5111 Clinton Dr
Kokomo IN 46902-7136
Phone: (765) 457-8381
Fax: (765) 457-4443
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01037768A | Indiana |
Profile Details
| NPI number | 1881718286 |
|---|---|
| LBN Legal business name | Wilson, Jeffrey K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 19th, 2007 |
| Last updated | Oct 24th, 2014 - 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 | 1881718286 | NPPES |
| Indiana | MEDICAID | 100319130E | |
| Indiana | Other | 000000524563 |
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