Wilson, Travis B

Wilson, Travis B is an individual health care provider with primary practice located at 140 W Main St Suite 100, Springfield OH 45502-1312. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Wilson, Travis B can be contacted via phone (937) 398-1066.

Contact Information

Primary practice address
140 W Main St Suite 100 Springfield OH 45502-1312
Phone: (937) 398-1066
Fax: (937) 398-1076
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 1140 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2723 Ohio

Profile Details

NPI number 1053408591
LBN Legal business name Wilson, Travis B
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 6th, 2006
Last updated Mar 7th, 2023 - about last year

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 1053408591 NPPES
Ohio Other 2723 PA LICENSE
Ohio Other 11949409 PA LICENSE

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