Wilson, John David

Wilson, John David is an individual health care provider with primary practice located at 495 Sw Ramsey Ave , Grants Pass OR 97527-5681. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adult Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Wilson, John David can be contacted via phone (541) 476-6644.

Contact Information

Primary practice address
495 Sw Ramsey Ave Grants Pass OR 97527-5681
Phone: (541) 476-6644
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X MD37095 Tennessee
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 150495 Oregon

Profile Details

NPI number 1104071224
LBN Legal business name Wilson, John David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 18th, 2008
Last updated Jul 6th, 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 1104071224 NPPES
Oregon MEDICAID 500622415

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