Wilson, Jeremy R

Wilson, Jeremy R is an individual health care provider with primary practice located at 2003 Stults Rd Ste 120 , Huntington IN 46750-1291. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Wilson, Jeremy R can be contacted via phone (260) 454-0425.

Contact Information

Primary practice address
2003 Stults Rd Ste 120 Huntington IN 46750-1291
Phone: (260) 454-0425
Fax: (260) 355-0299
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 02002760A Indiana

Profile Details

NPI number 1518930015
LBN Legal business name Wilson, Jeremy R
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2006
Last updated Jan 2nd, 2024 - about last year

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 1518930015 NPPES
Other 000000651390 ANTHEM
MEDICAID 200262010 ANTHEM

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