Bruce T. Wilson,D.M.D., PSC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5811 Issued in KY

Legal business name

BRUCE T. WILSON,D.M.D., PSC

Practice address

123 N 19TH St
Middlesboro, KY 40965-2865

Phone

(606) 248-1808

Fax

(606) 248-1803

NPI assigned

Oct 24, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bruce Taylor Wilson, DMD

Title

President

Phone

(606) 248-1808

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193184000000",
    "number": "1396924544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 N 19TH ST",
            "address_2": "PO BOX 1786",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652865",
            "telephone_number": "606-248-1808",
            "fax_number": "606-248-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 N 19TH ST",
            "city": "MIDDLESBORO",
            "state": "KY",
            "postal_code": "409652865",
            "telephone_number": "606-248-1808",
            "fax_number": "606-248-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUCE T. WILSON,D.M.D., PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2007-10-24",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "606-248-1808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "5811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64058118",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeremiah Hilton Brooks III, M.D.
• Rebekah Brooks
• Catherine Lynn Brown, RD
• Kimberly E Brown, APRN
• Lynda Lynn Browning, ANP
• Brooke Burchfield, OTR/L
• Harlie Burnett, FNP
• Marcena Mikel Byrne II, RPH
• Lloyd Lee Cain Jr., OD
• Richard D. Calhoun, DPM

• Oral and Maxillofacial Surgery (Dentist) in Middlesboro, KY
• Providers in Middlesboro, KY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.