Wilson, Jeffrey W

Wilson, Jeffrey W is an individual health care provider with primary practice located at 2137 Lakeside Dr. Ste 104, Lynchburg VA 24501-6806. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Wilson, Jeffrey W can be contacted via phone (434) 382-1005.

Contact Information

Primary practice address
2137 Lakeside Dr. Ste 104 Lynchburg VA 24501-6806
Phone: (434) 382-1005
Fax: (434) 316-7138
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0101030315 Virginia

Profile Details

NPI number 1245202498
LBN Legal business name Wilson, Jeffrey W
Credentials MD, MBA
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Aug 13th, 2013 - about 12 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 1245202498 NPPES
Virginia MEDICAID 1245202498
Virginia MEDICAID 6047718
Virginia Other 110064347
Virginia Other 541663754

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