Wilson, Gregory L

Wilson, Gregory L is an individual health care provider with primary practice located at 9709 E 79Th St , Tulsa OK 74133-4566. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM, Allopathic & Osteopathic Physicians / Neurological Surgery. Allopathic & Osteopathic Physicians / Neurological Surgery is his primary health care specialty. Wilson, Gregory L can be contacted via phone (918) 994-4000.

Contact Information

Primary practice address
9709 E 79Th St Tulsa OK 74133-4566
Phone: (918) 994-4000
Fax: (918) 994-4090
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM 204D00000X 2754 Oklahoma
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X 2754 Oklahoma

Profile Details

NPI number 1619030996
LBN Legal business name Wilson, Gregory L
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 18th, 2006
Last updated Aug 22nd, 2022 - about 4 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 1619030996 NPPES
Oklahoma MEDICAID 100125210A

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