Seth M Wilson, D.C.
Individual provider Active NPI Chiropractor · Seneca, MO
NPI 1093083271 · NPPES record last updated Oct 10, 2019
Key facts
- NPI
- 1093083271
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2011013813 (MO)
- Practice address
- 4556 Quince Rd
Seneca, MO 64865 - Phone
- (417) 776-4556
- NPI assigned
- Dec 2, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011013813 | MO | MD | Chiropractor |
| 15924 | AR | MD | Acupuncturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Management of Arkansas | Chiropractor | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 15924 | AR | |
| Acupuncturist | 171100000X | 15924 | AR | |
| Chiropractor | 111N00000X | 2011013813 | MO | Yes |
Addresses
Primary practice location
4556 Quince Rd
Seneca, MO 64865
Mailing address
4556 Quince Rd
Seneca, MO 64865-8037
Phone (417) 776-4556
Other practice location 1
636 W Broadway St
North Little Rock, AR 72114-5526
Phone (501) 374-1153 ext. 107
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801872304 | Other | AR | GROUP NPI |
| 15924 | Other | AR | LICENSE |
| 2011013813 | Other | MO | LICENSE |
Other providers in Seneca, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.