Wilson, Lori L

Wilson, Lori L is an sole proprietor health care provider with primary practice located at 104 Delaware Ave Suite 246, Uniontown PA 15401-3100. She recently has 4 registered licenses in different health care specialties including Other Service Providers / Contractor, Podiatric Medicine & Surgery Service Providers / Foot Surgery, Ambulatory Health Care Facilities / Podiatric, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is her primary health care specialty. Wilson, Lori L can be contacted via phone (724) 439-1300.

Contact Information

Primary practice address
104 Delaware Ave Suite 246 Uniontown PA 15401-3100
Phone: (724) 439-1300
Fax: (724) 439-8727
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X SC003555R Pennsylvania
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X SC003555R Pennsylvania
Ambulatory Health Care Facilities / Podiatric 261QP1100X SC003555R Pennsylvania
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X SC003555R Pennsylvania

Profile Details

NPI number 1679578249
LBN Legal business name Wilson, Lori L
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 20th, 2005
Last updated Jun 16th, 2018 - about 6 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 1679578249 NPPES
Pennsylvania MEDICAID 001214510003

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