Wilson, Richard D

Wilson, Richard D is an individual health care provider with primary practice located at 800 E Dawson St , Tyler TX 75701-2036. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Wilson, Richard D can be contacted via phone (903) 510-1186.

Contact Information

Primary practice address
800 E Dawson St Tyler TX 75701-2036
Phone: (903) 510-1186
Fax: (903) 525-1254
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G3095 Texas

Profile Details

NPI number 1609877000
LBN Legal business name Wilson, Richard D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Jun 12th, 2014 - about 12 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 1609877000 NPPES
Other 110162071 MCR RR
Other 75-2616977-042 MCR RR
Other 00064CV MCR RR
MEDICAID 079972801 MCR RR
Other 8EJ819 MCR RR

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