WALTER WRAY WILSON (NPI# 1639334048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639334048 |
| Entity Type | Individual |
| Full Name | WALTER WRAY WILSON |
| Credential | MD |
| Practice Address |
10221 Gibson Rd Hayden Lake ID 83835-9567 |
| Practice Telephone | 2087721912 |
| Mailing Telephone | 2087721912 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2008-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | M2288 | ID | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407267321 | Walter Harris Wilson | Dentist | 2290 Valleydale Rd Ste 100, Hoover, AL 35244-2113 | 2014-05-13 |
| 1821184334 | Walter W Wilson | Family Medicine | 1000 Saint Clair Rd, Springville, AL 35146-5582 | 2006-10-04 |
| 1649255407 | Walter Brad Wilson | Physical Therapist | 766 Highway 46 S, Dickson, TN 37055-2556 | 2005-12-14 |
| 1447790712 | Walter Wilson | Pharmacist | 1340 Airport Commerce Dr, Bld 3 Ste 350, Austin, TX 78741-6831 | 2017-03-06 |
| 1821485400 | Walter Wilson Jr. | Psychiatry & Neurology | 1401 Madison Ave, Covington, KY 41011-3313 | 2015-04-21 |
| 1346551009 | Walter A Wilson | Pharmacist | 1956 Greentree Rd, Pittsburgh, PA 15220-1813 | 2010-06-28 |
| 1679530356 | Walter Brad Wilson | Internal Medicine | 412 North St Ste E, Nacogdoches, TX 75961 | 2006-04-27 |
| 1982684940 | Walter R Wilson | Internal Medicine | 200 1st St Sw, Rochester, MN 55905 | 2006-01-18 |
| Street Address |
10221 GIBSON RD |
| City | HAYDEN LAKE |
| State | ID |
| Zip Code | 83835-9567 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881212371 | Ngan T Nguyen | Pharmacist | 161 E. Prairie Shopping Center, Hayden, ID 83835 | 2020-07-10 |
| 1689158461 | Rskiom, Pllc | Electrodiagnostic Medicine | 9323 N Government Way #6, Hayden, ID 83835 | 2018-09-18 |
| 1235616913 | Kimberly Jill Young | Dietitian, Registered | 8500 N. Atlas Rd., Hayden, ID 83835 | 2018-07-25 |
| 1851894380 | Medicine Man North Pharmacy Inc | Pharmacy | 30585 N Roberts Rd, Hayden, ID 83835 | 2018-03-11 |
| 1366997322 | Jennifer Amber Belmont | Social Worker | 8680 N Wayne Dr, Suite A, Hayden, ID 83835 | 2016-08-19 |
| 1548637994 | Dance Dentistry Pllc | Clinic/Center | 1027 W Prairie Ave, Hayden, ID 83835 | 2015-09-01 |
| 1982012498 | Dallin J. Dance | Dentist | 1027 W. Prairie Ave., Hayden, ID 83835 | 2014-07-28 |
| 1669808614 | Integrated Interventions LLC | Clinic/Center | 2482 E. Glacier Rd., Hayden Lake, ID 83835 | 2013-09-23 |
| 1669812301 | Caleb Jerome Foss | Physical Therapist | 8382 N Wayne Dr Ste 100, Hayden, ID 83835 | 2013-06-26 |
| 1437493798 | Joseph Neal Tessendorf | Chiropractor | 1401 Biztown Loop, Hayden, ID 83835 | 2012-11-26 |
| Find all providers in zip 83835 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699375659 | Jonathan Barrus Do PC | Family Medicine | 2020 S Johns Avenue, Emmett, ID 83617 | 2020-10-29 |
| 1750998126 | Story Family Medicine | Family Medicine | 1150 Alturas Dr Ste 101, Moscow, ID 83843-3263 | 2020-09-29 |
| 1780298430 | Alliance Medical Group, LLC | Family Medicine | Kuna Primary Health Medical Group, 1474 N. Meridian Road, Kuna, ID 83634 | 2020-09-01 |
| 1730711656 | Sara Marie Letham | Family Medicine | 33 S Thompson Lane, Blackfoot, ID 83221 | 2020-02-08 |
| 1447880570 | Bore LLC | Family Medicine | 1498 Midway Ave Ste 2, Ammon, ID 83406-4587 | 2020-01-16 |
| 1669038220 | Savannah M Klinginsmith | Family Medicine | 17866 Polara Way, Nampa, ID 83687-9159 | 2019-05-18 |
| 1487218814 | Logan Perkins | Family Medicine | 132 5th Ave W Ste 2, Jerome, ID 83338-1825 | 2019-05-01 |
| 1588227656 | Traci H Permenter | Family Medicine | 943 N Linder Rd Ste 103, Kuna, ID 83634-3395 | 2019-04-15 |
| 1790244424 | Destin Thayne Bep Inc | Family Medicine | 859 S Yellowstone Hwy Ste 304, Rexburg, ID 83440-5294 | 2019-03-12 |
| 1447718853 | Root Cause Integrative Medicine LLC | Family Medicine | 1547 S Midway Ave, Suite B, Ammon, ID 83406 | 2019-03-05 |
| Find all providers with the same taxonomy | ||||
| City | HAYDEN LAKE |
| Zip Code | 83835 |
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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.