Charles Bradford Wysong, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

E1192 Issued in TX

Practice address

130 S Central Expy
West Park Medical Center
McKinney, TX 75070-3742

Phone

(972) 548-5308

Fax

(972) 548-5433

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248912000000",
    "number": "1437113222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 740968",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753740968",
            "telephone_number": "800-945-2455",
            "fax_number": "903-453-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S CENTRAL EXPY",
            "address_2": "WEST PARK MEDICAL CENTER",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750703742",
            "telephone_number": "972-548-5308",
            "fax_number": "972-548-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYSONG",
        "first_name": "CHARLES",
        "middle_name": "BRADFORD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2009-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "E1192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126284203",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracey Rebecca Wright, PA-C
• Wwang Enterprises PLLC
• Jason Allen Wyatt, D.C,
• Precious M Wyatt, PHARMD.
• David Howard Wysinger, OD
• George Matthew Wysor, LCDC
• Xenia Maradiaga
• Helen Xu
• Amara Nicole Yachimski, LPC ASSOCIATE
• Menaka Yadav, DO

• Diagnostic Radiology Physician in McKinney, TX
• Providers in McKinney, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.