Wilson, Mark D.

Wilson, Mark D. is an individual health care provider with primary practice located at 401 W Jasper Dr , Killeen TX 76542-1323. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wilson, Mark D. can be contacted via phone (254) 298-2682.

Contact Information

Primary practice address
401 W Jasper Dr Killeen TX 76542-1323
Phone: (254) 298-2682
Fax: (254) 778-7197
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X F4697 Texas

Profile Details

NPI number 1447246491
LBN Legal business name Wilson, Mark D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2005
Last updated Oct 1st, 2012 - about 14 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 1447246491 NPPES
Texas MEDICAID 121277102

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