Wilson, Jon Daniel

Wilson, Jon Daniel is an individual health care provider with primary practice located at 10810 Executive Center Dr Ste 100 , Little Rock AR 72211-4386. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Wilson, Jon Daniel can be contacted via phone (501) 604-2695.

Contact Information

Primary practice address
10810 Executive Center Dr Ste 100 Little Rock AR 72211-4386
Phone: (501) 604-2695
Fax: (501) 604-2699
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 4301076903 Michigan

Profile Details

NPI number 1407816218
LBN Legal business name Wilson, Jon Daniel
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Nov 11th, 2015 - about 10 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1407816218 NPPES
Michigan MEDICAID 4244846
Michigan Other 220F362370

Popular Providers