WILSON INTERVENTIONAL CLINIC PA (NPI# 1467547141) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467547141 |
| Entity Type | Organization |
| Organization Name | WILSON INTERVENTIONAL CLINIC PA |
| Practice Address |
628 Hospital Dr Ste 3d Mountain Home AR 72653-2952 |
| Mailing Address |
Po Box 2008 Mountain Home AR 72654-2008 |
| Practice Telephone | 8704253737 |
| Practice Fax Number | 8704253742 |
| Mailing Telephone | 8704253737 |
| Mailing Fax Number | 8704253742 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2010-08-27 |
| Authorized Official Name | MATTHEW B WILSON (PRESIDENT) |
| Authorized Official Telephone | 8704253737 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
N-8297 | AR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | 149277002 | 05 |
| Street Address |
628 HOSPITAL DR STE 3D |
| City | MOUNTAIN HOME |
| State | AR |
| Zip Code | 72653-2952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513934 | Maranda Hickman | Physical Therapy Assistant | 347 Hwy 62 East College Plaza, Mountain Home, AR 72653 | 2019-11-21 |
| 1659929156 | Gale E Bacan | Technician | 1703 Monroe Ave, Mountain Home, AR 72653 | 2019-08-28 |
| 1891259321 | Kidspiration Pediatric Therapy Services | Clinic/Center | 710 Bradley Dr., Mountain Home, AR 72653 | 2019-01-29 |
| 1093279275 | Piper's Vision Xpress, LLC | Optometrist | 50 Paul Wood Lane, Mountian Home, AR 72653 | 2019-01-22 |
| 1346769155 | Heather Bollinger | Nurse Practitioner | 65 Walmart Drive, C/o Clinic At Walmart, Mountain Home, AR 72653 | 2017-09-12 |
| 1447774989 | Natalie D Ahrent | Physical Medicine & Rehabilitation | 804 Coley Dr, Mountain Home, AR 72653 | 2017-07-26 |
| 1417486028 | Andrew David Hatman | Case Manager/Care Coordinator | 1349 Hampshire Circle, Mountain Home, AR 72653 | 2017-06-07 |
| 1568848315 | Taylor Chiropractic Plc | Health Maintenance Organization | 103 S Main St Ste 5, Mountain Home, AR 72653 | 2015-08-04 |
| 1942606306 | Harps Food Stores, Inc | Pharmacy | 2089 Highway 62 West, Mountain Home, AR 72653 | 2014-11-13 |
| 1972920726 | Lavonne Armstrong | Counselor | 8 Medical Plaza, Mountain Home, AR 72653 | 2014-03-18 |
| Find all providers in zip 72653 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902168149 | Craig Anthony Robinson | Radiology | 69 Dogwood Avenue, Corner of Lamont Street and Veterans Way, Mountain Home, TN 37684 | 2012-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215028188 | William Combs Culp | Radiology | 4301 W Markham # 783, Little Rock, AR 72205-7101 | 2006-09-27 |
| 1699719799 | Interventional Radiology and Imaging Specialists, Pllc | Radiology | 4301 Greathouse Springs Rd., Suite # Rad Room 1064, Johnson, AR 72741 | 2006-06-16 |
| 1679527642 | Edward E Angtuaco | Radiology | 500 S University Ave Ste 101, Little Rock, AR 72205 | 2006-05-22 |
| 1194779991 | Charles T Burke | Radiology | 9601 Lile Drive, Suite 1100, Little Rock, AR 72205-6333 | 2006-05-19 |
| 1629617857 | Sarah Michelle Lindsey | Radiology | 9601 Baptist Health Dr, Little Rock, AR 72205-6321 | 2020-01-06 |
| 1144674409 | Pain & Interventional Radiology Specialists, P.a. | Radiology | 3800 E Johnson Ave, Ste E, Jonesboro, AR 72401-1931 | 2016-04-22 |
| 1225370810 | Erin E Priddy | Radiology | 4301 W Markham St # 556, Little Rock, AR 72205-7101 | 2013-03-21 |
| 1891051611 | Edgar St. Amour | Radiology | 8901 Carti Way, Little Rock, AR 72205-6523 | 2012-04-05 |
| 1174816235 | Joseph Steven Konrad | Radiology | 9601 Baptist Health Dr Ste 1100, Little Rock, AR 72205-6333 | 2011-05-24 |
| 1548552037 | William Joseph Meek | Radiology | 4301 W Markham St, Little Rock, AR 72205-7101 | 2011-05-03 |
| Find all providers with the same taxonomy | ||||
| City | MOUNTAIN HOME |
| Zip Code | 72653 |
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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.