THOMAS L WILSON M D LTD (NPI# 1275597817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1275597817 |
Entity Type | Organization |
Organization Name | THOMAS L WILSON M D LTD |
Practice Address |
814 W State Jacksonville IL 62650 |
Practice Telephone | 2172431865 |
Practice Fax Number | 2172436765 |
Mailing Telephone | 2172431865 |
Mailing Fax Number | 2172436765 |
Enumeration Date | 2006-04-12 |
Last Update Date | 2011-06-01 |
Authorized Official Name | CHARLES STOTT WILSON (PHYSICIAN) |
Authorized Official Telephone | 2172431865 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208800000X | Urology | 060001084 | IL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | 036043460 | 05 |
Street Address |
814 W STATE |
City | JACKSONVILLE |
State | IL |
Zip Code | 62650 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134768708 | Stephanie Lee Mabus | Occupational Therapy Assistant | 873 Gorve St, Jacksonville, IL 62650 | 2019-12-31 |
1285281071 | Sharshon Pharmacy Inc | Pharmacy | 154 W Morton Ave, Jacksonville, IL 62650 | 2019-08-26 |
1992275499 | Brittany Ruth Helmich | Counselor | 340 W. State St., Jacksonville, IL 62650 | 2018-11-28 |
1811391782 | Rodney E. Overstreet | Hearing Instrument Specialist | 1521 W. Walnut, Jacksonville, IL 62650 | 2014-10-21 |
1407979818 | Jan Ala | Speech-Language Pathologist | 1111 W Morton, Speechworks, Jacksonville, IL 62650 | 2007-04-09 |
1083787592 | Eldon G Barrowes Dds & Assoc PC | Dentist | 1515 West Walnut, Bldg #3, Jacksonville, IL 62650 | 2006-11-15 |
1194895979 | Joseph J Kozma | Internal Medicine | 1440 West Walnut, Jacksonville, IL 62650 | 2006-11-08 |
1740350529 | Susan Weller | Dentist | 1614 West Lafayette Avenue, Jackson, IL 62650 | 2006-11-08 |
1659467793 | Shawn M Fry | Family Medicine | 610 N. Westgate, Jacksonville, IL 62650 | 2006-10-05 |
1518050061 | Ward Richard Dunseth II | Nurse Anesthetist, Certified Registered | 1400 W Walnut, Jacksonville, IL 62650 | 2006-10-02 |
Find all providers in zip 62650 |
Taxonomy Code | 208800000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053859041 | Soroush Bazargani | Urology | 653 W 8th St Lrc Bldg Fl 2, Jacksonville, FL 32216-6511 | 2017-02-09 |
1538534409 | Clinical Urology Associates, P.C. | Urology | 820 Pelham Rd S, Jacksonville, AL 36265-2736 | 2015-12-03 |
1356692065 | Onslow Ambulatory Services, Inc. | Urology | 52 Office Park Dr, Suite B, Jacksonville, NC 28546-3217 | 2012-09-21 |
1841586120 | Travis Christopher Allemang | Urology | 2080 Child St Dept 5000, Jacksonville, FL 32214 | 2011-06-24 |
1164484267 | Charles Stott Wilson | Urology | 814 West State, Jacksonville, IL 62650 | 2006-04-04 |
1912967860 | Fawaz M Ashouri | Urology | 2301 University Blvd W, Jacksonville, FL 32217 | 2006-03-24 |
1972578136 | Christopher Ramon Williams | Urology | 8708 Perimeter Park Blvd Ste 4, Jacksonville, FL 32216 | 2006-02-21 |
1659374320 | Ahmad Kasraeian | Urology | 6269 Beach Blvd, Ste 2, Jacksonville, FL 32216-2705 | 2005-05-24 |
1013542919 | Ackerman Cancer Center, Pa | Urology | 10232 San Jose Blvd, Jacksonville, FL 32257 | 2020-03-11 |
1780241380 | Bryce Baird | Urology | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2019-05-20 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 62650 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.