Wilson, Philip J.

Wilson, Philip J. is an individual health care provider with primary practice located at 1241 W Stadium Blvd , Jefferson City MO 65109-6023. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Wilson, Philip J. can be contacted via phone (573) 556-7709.

Contact Information

Primary practice address
1241 W Stadium Blvd Jefferson City MO 65109-6023
Phone: (573) 556-7709
Fax: (573) 556-1709
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X R6C26 Missouri

Profile Details

NPI number 1114902327
LBN Legal business name Wilson, Philip J.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 9th, 2005
Last updated Aug 7th, 2008 - about 17 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 1114902327 NPPES
Missouri MEDICAID 241745801
Missouri Other 9218
Missouri Other 180032824
Missouri Other 106914
Missouri Other CP9089

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