Wilson, Nathan G

Wilson, Nathan G is an individual health care provider with primary practice located at 790 N. Hwy 67 , Florissant MO 63031-5108. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Wilson, Nathan G can be contacted via phone (314) 972-1442.

Contact Information

Primary practice address
790 N. Hwy 67 Florissant MO 63031-5108
Phone: (314) 972-1442
Fax: (314) 972-1533
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 070016087 Illinois

Profile Details

NPI number 1427230663
LBN Legal business name Wilson, Nathan G
Credentials LPT
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2007
Last updated Oct 21st, 2015 - about 9 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 1427230663 NPPES
Illinois Other 08220357 BCBS GROUP#

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