Wilson, John Fraser

Wilson, John Fraser is an individual health care provider with primary practice located at 8679 Connecticut St Ste A, Merrillville IN 46410-6383. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Wilson, John Fraser can be contacted via phone (219) 769-9022.

Contact Information

Primary practice address
8679 Connecticut St Ste A Merrillville IN 46410-6383
Phone: (219) 769-9022
Fax: (219) 769-1918
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 01049994A Indiana

Profile Details

NPI number 1538162151
LBN Legal business name Wilson, John Fraser
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Oct 28th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538162151 NPPES
Indiana MEDICAID 200202740

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