BRUCE T. WILSON,D.M.D., PSC (NPI# 1396924544) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396924544 |
| Entity Type | Organization |
| Organization Name | BRUCE T. WILSON,D.M.D., PSC |
| Practice Address |
123 N 19th St Middlesboro KY 40965-2865 |
| Mailing Address |
123 N 19th St Po Box 1786 Middlesboro KY 40965-2865 |
| Practice Telephone | 6062481808 |
| Practice Fax Number | 6062481803 |
| Mailing Telephone | 6062481808 |
| Mailing Fax Number | 6062481803 |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |
| Authorized Official Name | DR. BRUCE TAYLOR WILSON (PRESIDENT) |
| Authorized Official Telephone | 6062481808 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
5811 | KY | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64058118 | 05 |
| Street Address |
123 N 19TH ST |
| City | MIDDLESBORO |
| State | KY |
| Zip Code | 40965-2865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003816372 | Charles A Moore | Internal Medicine | 123 N 19th St, Suite 201, Middlesboro, KY 40965-2865 | 2005-07-28 |
| 1548673155 | Marcinia Michelle Bailey | Nurse Practitioner | 123 N 19th St, Suite A201, Middlesboro, KY 40965-2865 | 2014-06-11 |
| 1699195883 | Aimee Nicole Brock | Nurse Practitioner | 123 N 19th St, Middlesboro, KY 40965-2865 | 2014-04-26 |
| 1083996532 | Lynda Lynn Browning | Nurse Practitioner | 123 N 19th St, Middlesboro, KY 40965-2865 | 2011-09-11 |
| 1659551935 | Charles A Moore | Clinic/Center | 123 N 19th St, Suite 201, Middlesboro, KY 40965-2865 | 2007-11-05 |
| 1225220379 | Timothy L. Gardner, Dpm,pc | Podiatrist | 123 N 19th St, Middlesboro, KY 40965-2865 | 2007-08-13 |
| 1114133055 | Drs Rose and Thomas | Surgery | 123 N 19th St, Middlesboro, KY 40965 | 2007-05-15 |
| 1942250592 | Comprehensive Home Healthcare Services LLC | Case Management | 123 N 19th St, Suite 5, Middlesboro, KY 40965-2865 | 2006-05-12 |
| 1619978327 | Robert Lee Thomas Iv | Surgery | 123 N 19th St, Suite B301, Middlesboro, KY 40965-2865 | 2005-08-03 |
| 1881694271 | Medical Services of America Inc | Emergency Response System Companies | 123 N 19th St, Middlesboro, KY 40965-2865 | 2005-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396387064 | Christopher Bruce Ellison | Social Worker | 809 19th Street, Middlesboro, KY 40965 | 2019-10-14 |
| 1982255030 | Johnny Wade Nantz II | Case Manager/Care Coordinator | 809 N 19th St, Middlesboro, KY 40965 | 2019-09-20 |
| 1558827774 | August Pediatrics, LLC | Pediatrics | 123 N 19th St Ste 302, Middlesboro, KY 40965 | 2019-02-12 |
| 1558843227 | Bethany Lauren Wade | Case Manager/Care Coordinator | 19th St, 809, Middlesboro, KY 40965 | 2018-08-30 |
| 1124521505 | Sonya Joyce Mcneil | Speech-Language Pathologist | Kidabilities Pediatric Therapy Center, 2801 Highway 25e, Suite 98, Middlesboro, KY 40965 | 2018-03-13 |
| 1518499862 | Vikki Lynn Johnson | Case Manager/Care Coordinator | 809 North 19th Street, Middlesboro, KY 40965 | 2017-03-28 |
| 1184164287 | Wilson Jeffrey | Occupational Therapist | Address: 235 New Wilson Lane, Middlesboro, KY 40965 | 2017-03-08 |
| 1447797444 | Lesha Loretta Williams | Physician Assistant | 2004 Cumberland Ave Ste 100, Middlesboro, KY 40965 | 2017-01-27 |
| 1619423910 | Audra Anissa Hall | Physical Therapist | 108 Turner Lane, Middlesboro, KY 40965 | 2016-08-28 |
| 1700332061 | Tammy Mclain | Counselor | Selfrefind 809 North 19th Street, Middlesboro, KY 40965 | 2016-08-28 |
| Find all providers in zip 40965 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346294063 | Bruce Taylor Wilson | Dentist | 123 N 19th Street, Middlesboro, KY 40965-1786 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942705728 | Karah Lee Ellen Brown | Dentist | 800 Rose Street, Room D-508, Lexington, KY 40536 | 2018-03-26 |
| 1023510518 | Ralph M. Green Medical Pllc | Dentist | 3809 Poplar Level Rd Ste B, Louisville, KY 40213-1429 | 2018-03-01 |
| 1982058590 | Heine, Heine and Bowles, Pllc | Dentist | 2850 Lone Oak Rd Ste 5, Paducah, KY 42003-8043 | 2016-04-20 |
| 1326400789 | Corey Alan Taylor | Dentist | 800 Rose St # D-538, Lexington, KY 40536-7001 | 2016-03-24 |
| 1689060808 | Brandyn Herman | Dentist | Uk Dentistry At Turfland, 2195 Harrodsburg Rd, Ste 175, Lexington, KY 40536 | 2015-04-14 |
| 1619243268 | William J Curtis | Dentist | 800 Rose St Rm D508, University of Kentucky College of Dentistry, Lexington, KY 40536-0297 | 2012-03-28 |
| 1558651554 | Robbie James Harris IIi | Dentist | 4975 Alben Barkley Dr Ste 4, Paducah, KY 42001-6722 | 2011-04-11 |
| 1053541219 | Andrew William Ray | Dentist | 2421 Gooseberry Cir, Lexington, KY 40509-8567 | 2009-07-22 |
| 1407096639 | Charles William Langford Jr. | Dentist | 445 Stableford Cir, Owensboro, KY 42303-7771 | 2009-02-27 |
| 1477707784 | Nuckols & Cohron, P.s.c. | Dentist | 627 Eastwood St, Bowling Green, KY 42103-1688 | 2008-11-13 |
| Find all providers with the same taxonomy | ||||
| City | MIDDLESBORO |
| Zip Code | 40965 |
Please comment or provide details below to improve the information on BRUCE T. WILSON,D.M.D., PSC.
| 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.