Wilson, Mark E

Wilson, Mark E is an individual health care provider with primary practice located at 2055 N Main St , Tooele UT 84074-9819. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Wilson, Mark E can be contacted via phone (435) 843-3600.

Contact Information

Primary practice address
2055 N Main St Tooele UT 84074-9819
Phone: (435) 843-3600
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 3110304406 Utah

Profile Details

NPI number 1881608800
LBN Legal business name Wilson, Mark E
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2006
Last updated Dec 7th, 2009 - about 17 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 1881608800 NPPES
Utah Other 000061222 MEDICARE PTAN

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