Wilson, Wanda Gayle

Wilson, Wanda Gayle is an individual health care provider with primary practice located at 3559 Amazonas St , Jefferson City MO 65109. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Wilson, Wanda Gayle can be contacted via phone (573) 893-7848.

Contact Information

Primary practice address
3559 Amazonas St Jefferson City MO 65109
Phone: (573) 893-7848
Fax: (573) 893-1984
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X R8779 Missouri

Profile Details

NPI number 1033182118
LBN Legal business name Wilson, Wanda Gayle
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated Jun 30th, 2009 - about 17 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1033182118 NPPES
Other 9183317004 CIGNA
Other P00200365 CIGNA
Other 185418 CIGNA
MEDICAID 241488329 CIGNA
Other 829180 CIGNA
Other D41738 CIGNA
Other 251463 CIGNA

Popular Providers