Wilson, Mark Matthew
Wilson, Mark Matthew is an individual health care provider with primary practice located at 1337 Centre Ct , Alexandria LA 71301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Wilson, Mark Matthew can be contacted via phone (318) 445-9331.Contact Information
Primary practice address
1337 Centre Ct
Alexandria LA 71301
Phone: (318) 445-9331
Fax: (318) 619-6899
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 019488 | Louisiana |
Profile Details
| NPI number | 1295728087 |
|---|---|
| LBN Legal business name | Wilson, Mark Matthew |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2005 |
| Last updated | Aug 27th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295728087 | NPPES |
| Louisiana | MEDICAID | 1934780 |
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