Wilson, Thomas A
Wilson, Thomas A is an individual health care provider with primary practice located at 2478 13Th St Se , Salem OR 97302-2546. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wilson, Thomas A can be contacted via phone (503) 362-2481.Contact Information
Primary practice address
2478 13Th St Se
Salem OR 97302-2546
Phone: (503) 362-2481
Fax: (503) 371-7803
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD121816 | Oregon |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | MD12816 | Oregon |
Profile Details
| NPI number | 1679567085 |
|---|---|
| LBN Legal business name | Wilson, Thomas A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2005 |
| Last updated | Apr 23rd, 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 | 1679567085 | NPPES |
| Oregon | MEDICAID | 241166 |
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