Wilson, Jeffrey Whiteside

Wilson, Jeffrey Whiteside is an individual health care provider with primary practice located at 10229 W Greenfield Ave , West Allis WI 53214. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Wilson, Jeffrey Whiteside can be contacted via phone (414) 453-6330.

Contact Information

Primary practice address
10229 W Greenfield Ave West Allis WI 53214
Phone: (414) 453-6330
Fax: (414) 453-6523
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 15620 Wisconsin

Profile Details

NPI number 1417065715
LBN Legal business name Wilson, Jeffrey Whiteside
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2006
Last updated Aug 17th, 2010 - about 16 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 1417065715 NPPES
Other 11713 AMER BOARD OF PSYCH NEURO
MEDICAID 31772200 AMER BOARD OF PSYCH NEURO

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