Wilson, Ronald L

Wilson, Ronald L is an sole proprietor health care provider with primary practice located at 4620 Village Square Drive Suite 101, Paducah KY 42001-7501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wilson, Ronald L can be contacted via phone (270) 442-8575.

Contact Information

Primary practice address
4620 Village Square Drive Suite 101 Paducah KY 42001-7501
Phone: (270) 442-8575
Fax: (270) 442-8783
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 22453 Kentucky

Profile Details

NPI number 1376511063
LBN Legal business name Wilson, Ronald L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 9th, 2006
Last updated Dec 1st, 2020 - about 4 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 1376511063 NPPES
Kentucky Other 000000062924 BLUE CROSS ID NUMBER
Kentucky MEDICAID 64224538 BLUE CROSS ID NUMBER

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