Wilson, Jeffrey John

Wilson, Jeffrey John is an individual health care provider with primary practice located at 2017 Jefferson St Sw , Roanoke VA 24014-2419. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Allopathic & Osteopathic Physicians / Addiction Psychiatry, Allopathic & Osteopathic Physicians / Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Wilson, Jeffrey John can be contacted via phone (540) 853-0900.

Contact Information

Primary practice address
2017 Jefferson St Sw Roanoke VA 24014-2419
Phone: (540) 853-0900
Fax: (540) 853-0518
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 8225057 Utah
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X 8225057 Utah
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 8225057 Utah
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 0101-256187 Virginia
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 0101-256187 Virginia
Allopathic & Osteopathic Physicians / Addiction Psychiatry 2084P0802X 0101-256187 Virginia

Profile Details

NPI number 1811015092
LBN Legal business name Wilson, Jeffrey John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2007
Last updated Dec 24th, 2014 - about 12 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 1811015092 NPPES
Virginia Other VVD703A MEDICARE PTAN

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