Wilson, William Randolph

Wilson, William Randolph is an individual health care provider with primary practice located at 207 Three Bridges Rd , Greenville SC 29611-7549. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Wilson, William Randolph can be contacted via phone (864) 220-1110.

Contact Information

Primary practice address
207 Three Bridges Rd Greenville SC 29611-7549
Phone: (864) 220-1110
Fax: (864) 220-1104
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 11947 South Carolina

Profile Details

NPI number 1093784860
LBN Legal business name Wilson, William Randolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2006
Last updated Jun 23rd, 2021 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093784860 NPPES
South Carolina Other 11947 SC LICENSE
South Carolina MEDICAID 119473 SC LICENSE

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