Wilson, Mark Vincent
Wilson, Mark Vincent is an individual health care provider with primary practice located at 240 Riverside Dr , Johnson City NY 13790-2732. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Wilson, Mark Vincent can be contacted via phone (607) 798-9356.Contact Information
Primary practice address
240 Riverside Dr
Johnson City NY 13790-2732
Phone: (607) 798-9356
Fax: (607) 797-1707
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | 220358 | New York |
Profile Details
| NPI number | 1215951579 |
|---|---|
| LBN Legal business name | Wilson, Mark Vincent |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 27th, 2006 |
| Last updated | Mar 23rd, 2021 - about 4 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 | 1215951579 | NPPES |
| New York | MEDICAID | 02663610 |
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