Wilson, Gary A

Wilson, Gary A is an individual health care provider with primary practice located at 311 N Clyde Morris Blvd , Daytona Beach FL 32114-2781. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Wilson, Gary A can be contacted via phone (386) 947-4650.

Contact Information

Primary practice address
311 N Clyde Morris Blvd Daytona Beach FL 32114-2781
Phone: (386) 947-4650
Fax: (386) 947-4690
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 34858 Iowa

Profile Details

NPI number 1215933056
LBN Legal business name Wilson, Gary A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Jul 10th, 2009 - about 17 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 1215933056 NPPES
Iowa MEDICAID 0276915

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