Wilson, Keith A

Wilson, Keith A is an individual health care provider with primary practice located at 10 Dutton Dr , Youngstown OH 44502-1818. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Wilson, Keith A can be contacted via phone (330) 746-7691.

Contact Information

Primary practice address
10 Dutton Dr Youngstown OH 44502-1818
Phone: (330) 746-7691
Fax: (330) 743-8368
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 35-052784 Ohio

Profile Details

NPI number 1164424743
LBN Legal business name Wilson, Keith A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Feb 9th, 2016 - about 10 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 1164424743 NPPES
Ohio Other 438220 KEYSTONE
Ohio Other 82799 KEYSTONE
Ohio Other 0800328 KEYSTONE
Ohio Other 180011155 KEYSTONE
Ohio Other 4096251 KEYSTONE
Ohio Other 0095849000 KEYSTONE
Ohio MEDICAID 0624695 KEYSTONE
Ohio Other Z52784 KEYSTONE
Ohio Other 000000126322 KEYSTONE

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