Wilson, Richard C

Wilson, Richard C is an individual health care provider with primary practice located at 1515 Dr Martin Luther King Jr Blvd , Melbourne FL 32901-2946. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Wilson, Richard C can be contacted via phone (321) 723-3500.

Contact Information

Primary practice address
1515 Dr Martin Luther King Jr Blvd Melbourne FL 32901-2946
Phone: (321) 723-3500
Fax: (321) 723-1945
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 421 Colorado
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016003144 Illinois
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X PO1322 Florida

Profile Details

NPI number 1972587350
LBN Legal business name Wilson, Richard C
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 30th, 2005
Last updated May 12th, 2023 - about 2 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 1972587350 NPPES
Florida MEDICAID 041009800
Florida Other 87733

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