Wilson, Gary L

Wilson, Gary L is an individual health care provider with primary practice located at 1000 Breckenridge St Suite 404, Owensboro KY 42303-0878. He recently has only one registered license in Allopathic & Osteopathic Physicians / Infectious Disease, which is considered as his primary health care specialty. Wilson, Gary L can be contacted via phone (270) 691-8050.

Contact Information

Primary practice address
1000 Breckenridge St Suite 404 Owensboro KY 42303-0878
Phone: (270) 691-8050
Fax: (270) 691-8051
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X 42171 Kentucky

Profile Details

NPI number 1225025935
LBN Legal business name Wilson, Gary L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2005
Last updated May 2nd, 2019 - about 7 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 1225025935 NPPES
Kentucky MEDICAID 7100065360
Kentucky Other 000000588181

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