Wilson, Jack J

Wilson, Jack J is an individual health care provider with primary practice located at 5801 Bremo Rd , Richmond VA 23226-1907. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Wilson, Jack J can be contacted via phone (804) 281-8100.

Contact Information

Primary practice address
5801 Bremo Rd Richmond VA 23226-1907
Phone: (804) 281-8100
Fax: (804) 285-7419
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X ME58840 Florida
Allopathic & Osteopathic Physicians / Hematology 207ZH0000X 58840 Florida
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 58840 Florida
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 304638 Louisiana

Profile Details

NPI number 1851378145
LBN Legal business name Wilson, Jack J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2005
Last updated Jan 29th, 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 1851378145 NPPES
Florida MEDICAID 052455700

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