Wilson, Brent C
Wilson, Brent C is an individual health care provider with primary practice located at 4300 W Memorial Rd , Oklahoma City OK 73120-8304. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medical Services, which is considered as his primary health care specialty. Wilson, Brent C can be contacted via phone (405) 752-3715.Contact Information
Primary practice address
4300 W Memorial Rd
Oklahoma City OK 73120-8304
Phone: (405) 752-3715
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | 17280 | Oklahoma |
Profile Details
| NPI number | 1760440879 |
|---|---|
| LBN Legal business name | Wilson, Brent C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2006 |
| Last updated | May 21st, 2014 - about 12 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 | 1760440879 | NPPES |
| Oklahoma | MEDICAID | 100213520B |
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