Wilson, Joan

Wilson, Joan is an individual health care provider with primary practice located at 2212 Wilborn Ave , South Boston VA 24592-1630. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Wilson, Joan can be contacted via phone (434) 572-8921.

Contact Information

Primary practice address
2212 Wilborn Ave South Boston VA 24592-1630
Phone: (434) 572-8921
Fax: (434) 572-2063
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 0101034828 Virginia

Profile Details

NPI number 1124097282
LBN Legal business name Wilson, Joan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2006
Last updated Feb 17th, 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 1124097282 NPPES
Virginia Other 240940 BCBS
Virginia MEDICAID 006207561 BCBS
Virginia Other 48092 BCBS

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