Kent Shannon Wilson in Woodbury - Surgery
Kent Shannon Wilson - NPI 1922044288
Kent Shannon Wilson is a Surgery in Woodbury, Minnesota. Kent Shannon Wilson practices all healthcare services and medical treatments related to Surgery. The NPI Number for Kent Shannon Wilson is 1922044288. The last update date is 2009-12-04.
Kent Shannon Wilson's current location address is 2080 Woodwinds Drive, Woodbury, Minnesota. You can contact this provider via phone number 6517020750 and fax number 6516456166. The mailing address for Kent Shannon Wilson is 2080 Woodwinds Drive, Woodbury, Minnesota. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kent Shannon Wilson |
|---|---|
| Address | 2080 Woodwinds Drive, Woodbury, Minnesota |
| Phone Number | 6517020750 |
| Fax Number | 6516456166 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1922044288 |
|---|---|
| Provider Enumeration Date | 2006-06-22 |
| Last Updated Date | 2009-12-04 |
Provider Mailing Address Detail
| Address | 2080 Woodwinds Drive |
|---|---|
| City | Woodbury |
| State | Minnesota (MN) |
| Post Code | 55125 |
| Phone Number | 6517020750 |
| Fax Number | 6516456166 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 17805 |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 905070100 | MN | -- |
Post Comment/ Review Below
What is the Kent Shannon Wilson's unique identification number?
The Kent Shannon Wilson has been assigned the NPI (National Provider Identifier) Number 1922044288 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please share the complete physical address where Kent Shannon Wilson is geographically located?
The Kent Shannon Wilson is physically situated at the following location: 2080 Woodwinds Drive, Woodbury, MN, 55125.
What is Kent Shannon Wilson's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Kent Shannon Wilson is Surgery, and the taxonomy code that categorizes this field of expertise is 208600000X.
On what date did the Kent Shannon Wilson receive the assignment of its 1922044288 from the Centers for Medicare & Medicaid Services?
The Kent Shannon Wilson was issued its 1922044288 by the Centers for Medicare & Medicaid Services on 2006-06-22.
When was the information regarding Kent Shannon Wilson most recently updated?
The details pertaining to the Kent Shannon Wilson, including its address, specialty, and other relevant information, were last refreshed on 2009-12-04.