Wilson, William Cassidy
Wilson, William Cassidy is an individual health care provider with primary practice located at 510 S Kingshighway Blvd , Saint Louis MO 63110-1016. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Body Imaging. Allopathic & Osteopathic Physicians / Body Imaging is his primary health care specialty. Wilson, William Cassidy can be contacted via phone (314) 362-7200.Contact Information
Primary practice address
510 S Kingshighway Blvd
Saint Louis MO 63110-1016
Phone: (314) 362-7200
Fax: (314) 747-4189
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 2019009534 | Missouri |
| Allopathic & Osteopathic Physicians / Body Imaging | 2085B0100X | 2019009534 | Missouri |
Profile Details
| NPI number | 1366861841 |
|---|---|
| LBN Legal business name | Wilson, William Cassidy |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2014 |
| Last updated | Jul 2nd, 2019 - about 5 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 | 1366861841 | NPPES |
| Illinois | MEDICAID | ENROLLED | |
| Illinois | MEDICAID | 200067605 |
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