Wilson, Theodore Ernest
Wilson, Theodore Ernest is an sole proprietor health care provider with primary practice located at 411 E Chestnut St , Louisville KY 40202-1713. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.). Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) is his primary health care specialty. Wilson, Theodore Ernest can be contacted via phone (502) 588-0850.Contact Information
Primary practice address
411 E Chestnut St
Louisville KY 40202-1713
Phone: (502) 588-0850
Fax: (502) 588-0861
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 01079354A | Indiana |
| Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | 01079354A | Indiana |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | P27658 | Maryland |
| Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | TP230 | Kentucky |
Profile Details
| NPI number | 1699035030 |
|---|---|
| LBN Legal business name | Wilson, Theodore Ernest |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 18th, 2012 |
| Last updated | Jul 24th, 2026 - about 3 months 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 | 1699035030 | NPPES |
| Indiana | Other | 000001126408 | ANTHEM PTAN |
| Indiana | Other | 1102391322 | ANTHEM PTAN |
| Indiana | MEDICAID | 300007251 | ANTHEM PTAN |
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