Wilson, Robert Bruce

Wilson, Robert Bruce is an individual health care provider with primary practice located at 1200 Lacrosse Street Suite 105, Rapid City SD 57701. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wilson, Robert Bruce can be contacted via phone (605) 348-9369.

Contact Information

Primary practice address
1200 Lacrosse Street Suite 105 Rapid City SD 57701
Phone: (605) 348-9369
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 447 South Dakota

Profile Details

NPI number 1710107909
LBN Legal business name Wilson, Robert Bruce
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 27th, 2007
Last updated Jul 8th, 2007 - about 19 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 1710107909 NPPES
South Dakota MEDICAID 9202230

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