Wilson, Jacqueline S
Wilson, Jacqueline S is an sole proprietor health care provider with primary practice located at 321 E Main St Suite 309, Bozeman MT 59715-6241. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Wilson, Jacqueline S can be contacted via phone (406) 586-7515.Contact Information
Primary practice address
321 E Main St Suite 309
Bozeman MT 59715-6241
Phone: (406) 586-7515
Fax: (406) 522-0481
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 8315 | Montana |
Profile Details
| NPI number | 1568403640 |
|---|---|
| LBN Legal business name | Wilson, Jacqueline S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Mar 17th, 2008 - about 18 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 | 1568403640 | NPPES |
| Montana | MEDICAID | 0152425 | |
| Montana | Other | 93296 |
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