Kevin William Wilson in State College - Sports Medicine
Kevin William Wilson - NPI 1790980381
Kevin William Wilson is a Sports Medicine in State College, Pennsylvania. Kevin William Wilson practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Kevin William Wilson is 1790980381. The last update date is 2019-07-29.
Kevin William Wilson's current location address is 1700 Old Gatesburg Rd Ste 200, State College, Pennsylvania. You can contact this provider via phone number 8142374321 and fax number 8142350484. The mailing address for Kevin William Wilson is 1700 Old Gatesburg Rd Ste 200, State College, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin William Wilson |
|---|---|
| Address | 1700 Old Gatesburg Rd Ste 200, State College, Pennsylvania |
| Phone Number | 8142374321 |
| Fax Number | 8142350484 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1790980381 |
|---|---|
| Provider Enumeration Date | 2007-06-15 |
| Last Updated Date | 2019-07-29 |
Provider Mailing Address Detail
| Address | 1700 Old Gatesburg Rd Ste 200 |
|---|---|
| City | State College |
| State | Pennsylvania (PA) |
| Post Code | 168032276 |
| Phone Number | 8142374321 |
| Fax Number | 8142350484 |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Xx0005X |
| Licence No | MD468320 |
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Definition: An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, train |
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What is the unique 10-digit identification code issued to Kevin William Wilson by the Centers for Medicare & Medicaid Services?
The Kevin William Wilson has been assigned the NPI (National Provider Identifier) 1790980381 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Kevin William Wilson located?
The Kevin William Wilson is located at 1700 Old Gatesburg Rd Ste 200, State College, PA 168032276.
What is the Kevin William Wilson's specialty and taxonomy code?
The Kevin William Wilson's specialty is Sports Medicine, and the corresponding taxonomy code is 207Xx0005X.
On what date was the 1790980381 assigned to Kevin William Wilson?
The Kevin William Wilson was issued its 1790980381 on 2007-06-15, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Kevin William Wilson most recently updated or revised?
The information pertaining to Kevin William Wilson, including its address, specialty, and other relevant details, was last updated or revised on 2019-07-29.