Wilson, Matthew Baker

Wilson, Matthew Baker is an individual health care provider with primary practice located at 624 Hospital Dr , Mountain Home AR 72653-2955. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Wilson, Matthew Baker can be contacted via phone (870) 425-6322.

Contact Information

Primary practice address
624 Hospital Dr Mountain Home AR 72653-2955
Phone: (870) 425-6322
Fax: (870) 424-5859
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X N-8297 Arkansas
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X N-8297 Arkansas

Profile Details

NPI number 1578538575
LBN Legal business name Wilson, Matthew Baker
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 22nd, 2006
Last updated Aug 18th, 2010 - about 15 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 1578538575 NPPES
Arkansas MEDICAID 123676001

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