Kevin Wilson is a Medical in Belleville, Illinois. Kevin Wilson practices all healthcare services and medical treatments related to Medical. The NPI Number for Kevin Wilson is 1063424984. The last update date is 2016-03-21.
Kevin Wilson's current location address is 4500 Memorial Drive, Belleville, Illinois. You can contact this provider via phone number 6182574644 and fax number 6182576946. The mailing address for Kevin Wilson is 4500 Memorial Drive, Belleville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin Wilson |
|---|---|
| Address | 4500 Memorial Drive, Belleville, Illinois |
| Phone Number | 6182574644 |
| Fax Number | 6182576946 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1063424984 |
|---|---|
| Provider Enumeration Date | 2006-08-12 |
| Last Updated Date | 2016-03-21 |
Provider Mailing Address Detail
| Address | 4500 Memorial Drive |
|---|---|
| City | Belleville |
| State | Illinois (IL) |
| Post Code | 62226 |
| Phone Number | 6182574644 |
| Fax Number | 6182576946 |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | 085-000488 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 085-000488 | IL | STATE LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Kevin Wilson by the Centers for Medicare & Medicaid Services?
The Kevin Wilson has been issued the NPI (National Provider Identifier) 1063424984 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Kevin Wilson located?
The Kevin Wilson is located at 4500 Memorial Drive, Belleville, IL 62226.
What is Kevin Wilson's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Kevin Wilson is Medical, and the taxonomy code that classifies this field of practice is 363Am0700X.
On what date did the Centers for Medicare & Medicaid Services assign the 1063424984 to Kevin Wilson?
The Centers for Medicare & Medicaid Services assigned the 1063424984 to Kevin Wilson on 2006-08-12.
When was the information regarding Kevin Wilson, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Kevin Wilson, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2016-03-21.