Wilson, Douglas A

Wilson, Douglas A is an individual health care provider with primary practice located at 930 Sw Abbey St Ste B , Newport OR 97365-4820. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Wilson, Douglas A can be contacted via phone (541) 574-7235.

Contact Information

Primary practice address
930 Sw Abbey St Ste B Newport OR 97365-4820
Phone: (541) 574-7235
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 4301056816 Michigan
Allopathic & Osteopathic Physicians / Surgery 208600000X M10679 Idaho
Allopathic & Osteopathic Physicians / Surgery 208600000X MD157658 Oregon

Profile Details

NPI number 1679502918
LBN Legal business name Wilson, Douglas A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Mar 7th, 2023 - about 2 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 1679502918 NPPES
Idaho Other 77943 BLUE CROSS
Idaho MEDICAID 808373700 BLUE CROSS
Idaho Other 0249855 BLUE CROSS
Idaho MEDICAID 1679502918 BLUE CROSS
Idaho Other 000010173389 BLUE CROSS
Idaho Other 0201174022 BLUE CROSS
Idaho MEDICAID 1679502918 BLUE CROSS
Idaho Other 20039075 BLUE CROSS

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