Wilson, Michael R
Wilson, Michael R is an individual health care provider with primary practice located at 1300 E Zion Rd , Fayetteville AR 72703-5015. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Wilson, Michael R can be contacted via phone (479) 521-8980.Contact Information
Primary practice address
1300 E Zion Rd
Fayetteville AR 72703-5015
Phone: (479) 521-8980
Fax: (479) 521-8982
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | E-3255 | Arkansas |
Profile Details
| NPI number | 1417914813 |
|---|---|
| LBN Legal business name | Wilson, Michael R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 28th, 2006 |
| Last updated | Sep 8th, 2008 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417914813 | NPPES |
| Arkansas | MEDICAID | 146880001 |
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