Wilson, Marty C

Wilson, Marty C is an individual health care provider with primary practice located at 1301 S Koke Mill Rd , Springfield IL 62711-9252. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Wilson, Marty C can be contacted via phone (217) 547-9100.

Contact Information

Primary practice address
1301 S Koke Mill Rd Springfield IL 62711-9252
Phone: (217) 547-9100
Fax: (217) 547-9236
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 085004959 Illinois

Profile Details

NPI number 1184045338
LBN Legal business name Wilson, Marty C
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 13th, 2013
Last updated Apr 13th, 2020 - about 5 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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