Wilson, Shawn
Wilson, Shawn is an sole proprietor health care provider with primary practice located at 880 W Eden Cir , Fayetteville AR 72701-6931. He recently has only one registered license in Other Service Providers / Contractor, which is considered as his primary health care specialty. Wilson, Shawn can be contacted via phone (479) 445-2781.Contact Information
Primary practice address
880 W Eden Cir
Fayetteville AR 72701-6931
Phone: (479) 445-2781
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Contractor | 171W00000X | 208211783 | Arkansas |
Profile Details
| NPI number | 1598141525 |
|---|---|
| LBN Legal business name | Wilson, Shawn |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 31st, 2015 |
| Last updated | Jul 31st, 2015 - about 10 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 | 1598141525 | NPPES |
| Arkansas | MEDICAID | 208211783 |
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