Dr Bradley C Wilson Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

34004144 Issued in OH

Legal business name

DR BRADLEY C WILSON INC

Practice address

7756 St RT 37 East
New Lexington, OH 43764

Phone

(740) 342-3540

Fax

(740) 342-3879

NPI assigned

Jan 25, 2007

Last updated

Nov 18, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bradley C Wilson, DONPI 1225020878

Title

President

Phone

(740) 342-3540

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley C Wilson, DO

  • Family Medicine Physician
  • New Lexington, OH
  • NPI 1225020878
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1164577367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 550",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431300550",
            "telephone_number": "740-687-5164",
            "fax_number": "740-654-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7756 ST RT 37 EAST",
            "city": "NEW LEXINGTON",
            "state": "OH",
            "postal_code": "43764",
            "telephone_number": "740-342-3540",
            "fax_number": "740-342-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR BRADLEY C WILSON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "740-342-3540",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "34004144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2973215",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Devolld
• Robert J Dittoe, O.D.
• Renea Lynn Dodson, LSW
• Cecelia Ann Dorr, LPN LICENSED PRACTIC
• Susan J Dorsky, MA, PHD, LSW
• Mariah L Dunay
• Molly Jo Dupler, RN, BSN
• Amanda J Dyer
• Emily Edgington, LSW
• Emily R Ehre, LISW

• Family Medicine Physician in New Lexington, OH
• Providers in New Lexington, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.