Wilson, Gregory J
Wilson, Gregory J is an individual health care provider with primary practice located at 2505 Green Tech Dr Ste C , State College PA 16803-2316. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Rheumatology. Allopathic & Osteopathic Physicians / Rheumatology is his primary health care specialty. Wilson, Gregory J can be contacted via phone (814) 235-0484.Contact Information
Primary practice address
2505 Green Tech Dr Ste C
State College PA 16803-2316
Phone: (814) 235-0484
Fax: (814) 234-7587
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | OS-013257 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2010015957 | Missouri |
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | OS013257 | Pennsylvania |
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | O-0777 | Idaho |
Profile Details
| NPI number | 1669406799 |
|---|---|
| LBN Legal business name | Wilson, Gregory J |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 11th, 2006 |
| Last updated | Jun 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669406799 | NPPES |
| Idaho | MEDICAID | 1669406799 | |
| Idaho | MEDICAID | 101334728 | |
| Idaho | MEDICAID | 1013347280004 |
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