Active NPI
Mark Stephen Wilson II, M.D.
- Orthopaedic Surgery Physician
- Tulsa, OK
National Provider Identifier
1225233604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 24648
- Practice address
- 5591 S Lewis Ave
Tulsa, OK 74105-7132 - Phone
- (918) 488-8285
- NPI assigned
- Jun 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | TRN10336 | FL | |
| Orthopaedic Surgery Physician | 207X00000X | 24648 | OK | Primary |
Addresses
Primary practice location
5591 S Lewis Ave
Tulsa, OK 74105-7132
Mailing address
7908 S Frisco Ave
Tulsa, OK 74132-2813
Phone (918) 935-4590
Other practice location 1
2821 NW 50th St
Oklahoma City, OK 73112-8090
Phone (405) 606-6886
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TRN10336 | FL | MD | Orthopaedic Surgery Physician |
| 24648 | OK | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rmo - Tulsa, PLLC | Orthopaedic Surgery | Past | Accepting new patients |
| Jackson County Memorial Hospital Authority | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Medicine & Rehabilitation Physician
- Tulsa, OK
- NPI 1881099414
Orthopaedic Surgery
-
- General Acute Care Hospital
- Altus, OK
- NPI 1093763781
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612915200000",
"number": "1225233604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7908 S FRISCO AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741322813",
"telephone_number": "918-935-4590"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5591 S LEWIS AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741057132",
"telephone_number": "918-488-8285"
}
],
"practiceLocations": [
{
"address_1": "2821 NW 50th St",
"address_purpose": "LOCATION",
"city": "Oklahoma City",
"state": "OK",
"postal_code": "731128090",
"country_code": "US",
"telephone_number": "405-606-6886",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "MARK",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"name_suffix": "II",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-18",
"last_updated": "2021-02-10",
"certification_date": "2021-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "FL",
"license": "TRN10336",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "OK",
"license": "24648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.