Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 101035718 | VA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 101035718 | VA |
NPI | 1215978754 |
---|---|
Provider Name | Dr. Jeffrey Kent Wilson |
First Address | North Chesterfield, VA 23225-4067 |
Second Address | Mechanicsville, VA 23116-2331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 19/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006403379 | (05) | VA |
052664 | ANTHEM HEALTHKEEPERS (01) | VA |
05367828 | AETNA HMO (01) | VA |
0900108 | UNITED HEALTHCARE (01) | VA |
1215978754 | (05) | VA |
200020605 | RAILROAD MEDICARE (01) | VA |
2138346 | UNITED HEALTHCARE MAMSI (01) | VA |
285655 | SOUTHERN HEALTH (01) | VA |
32147 | SH CARENET (01) | VA |
386544 | ANTHEM WEST END OPERATORY (01) | VA |
46427 | OPTIMA HEALTH (01) | VA |
540885859 | C&O EMPLOYEES HEALTHCARE (01) | VA |
540885859 | CIGNA (01) | VA |
540885859 | COMPMANAGEMENT (01) | VA |
540885859 | CORVEL (01) | VA |
540885859 | FIRST HEALTH/CCN (01) | VA |
540885859 | FOCUS (01) | VA |
540885859 | PRIVATE HEALTHCARE SYSTEM (01) | VA |
B08803 | (02) | VA |