Wilson, Timothy Jon

Wilson, Timothy Jon is an individual health care provider with primary practice located at 2413 Wards Rd , Lynchburg VA 24502-2103. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wilson, Timothy Jon can be contacted via phone (434) 239-5323.

Contact Information

Primary practice address
2413 Wards Rd Lynchburg VA 24502-2103
Phone: (434) 239-5323
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0618000530 Virginia
Eye and Vision Services Providers / Optometrist 152W00000X 0618000652 Virginia

Profile Details

NPI number 1013946615
LBN Legal business name Wilson, Timothy Jon
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Jul 1st, 2011 - about 15 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 1013946615 NPPES
Virginia MEDICAID 9230122
Virginia MEDICAID 9234501

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