JOESPH THOMAS WILSON JR. (NPI# 1366576720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366576720 |
| Entity Type | Individual |
| Full Name | JOESPH THOMAS WILSON JR. |
| Credential | M.D. |
| Practice Address |
411 E Matthews Ave Jonesboro AR 72401-3142 |
| Mailing Address |
Po Box 1326 Jonesboro AR 72403-1326 |
| Practice Telephone | 8709303518 |
| Practice Fax Number | 8709303569 |
| Mailing Telephone | 8709303518 |
| Mailing Fax Number | 8709303569 |
| Enumeration Date | 2007-03-15 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
C3057 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | BCBS PROVIDER NUMBER | 55763 | 01 |
| Street Address |
411 E MATTHEWS AVE |
| City | JONESBORO |
| State | AR |
| Zip Code | 72401-3142 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487692695 | Stephen Wayne Locke | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2006-06-02 |
| 1336568385 | Kimberly Frances Ingersoll | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2014-04-07 |
| 1043537608 | Jamie M Boone | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2010-04-22 |
| 1437283470 | Philip Ellis Ferguson | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2007-03-14 |
| 1477600294 | Ashton Byington | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2007-01-04 |
| 1417046137 | Doctors' Pathology Services, Pa | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401 | 2006-10-12 |
| 1508872904 | Doctors' Anatomic Pathology Services, Pa | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2006-07-31 |
| 1588684369 | Doctors' Pathology Services, Pa | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2006-07-21 |
| 1871520999 | Deborah Ann Johnson | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2006-06-26 |
| 1114953957 | Dwight Franklin Boggs | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2006-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
| 1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
| 1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
| 1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
| 1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
| 1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
| 1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
| 1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
| 1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
| 1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
| Find all providers in zip 72401 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487692695 | Stephen Wayne Locke | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2006-06-02 |
| 1336568385 | Kimberly Frances Ingersoll | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2014-04-07 |
| 1043537608 | Jamie M Boone | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2010-04-22 |
| 1437283470 | Philip Ellis Ferguson | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2007-03-14 |
| 1477600294 | Ashton Byington | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2007-01-04 |
| 1417046137 | Doctors' Pathology Services, Pa | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401 | 2006-10-12 |
| 1407943616 | Doctors' Pathology Services, Pa | Pathology | 3024 Stadium Blvd, Jonesboro, AR 72401 | 2006-10-07 |
| 1699781096 | Doctors' Anatomic Pathology Services, Pa | Pathology | 3024 Stadium Blvd, Jonesboro, AR 72401-7415 | 2006-07-31 |
| 1508872904 | Doctors' Anatomic Pathology Services, Pa | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2006-07-31 |
| 1588684369 | Doctors' Pathology Services, Pa | Pathology | 411 E Matthews Ave, Jonesboro, AR 72401-3142 | 2006-07-21 |
| Find all providers in JONESBORO | ||||
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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.