Wilson ENT PSC

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

34426 Issued in KY

Legal business name

WILSON ENT PSC

Practice address

102 C Physicians Blvd
Glasgow, KY 42141

Phone

(270) 651-2433

Fax

(270) 651-2949

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Lee Wilson, MD

Title

Preseident

Phone

(270) 651-2433

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231977600000",
    "number": "1336249127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1088",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421421088",
            "telephone_number": "270-651-2433",
            "fax_number": "270-651-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 C PHYSICIANS BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "42141",
            "telephone_number": "270-651-2433",
            "fax_number": "270-651-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON ENT PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2009-01-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESEIDENT",
        "authorized_official_telephone_number": "270-651-2433",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "KY",
            "license": "34426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65932428",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DN6242",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID",
            "identifier": "000000065313",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William F Marrs
• William T. Thistlethwaite M.D. PLLC
• Ashley Rae Williams, APRN
• Rhonda Sue Williams, LPCA
• Riley Glee Williams, PHARMD
• Jeffrey Lee Wilson, M.D.
• Michelle A Wilson, APRN
• Nakeisha Brooke Wilson, LCSW
• Nicole Wilson
• Shae Wilson

• Otolaryngology Physician in Glasgow, KY
• Providers in Glasgow, KY by specialty
• Otolaryngology Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.