William Wilson MD PC

Primary specialty

Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X

License

M 5527 Issued in ID

Legal business name

WILLIAM WILSON MD PC

Practice address

2860 Channing Way Ste 112
Idaho Falls, ID 83404-7532

Phone

(208) 524-4381

Fax

(208) 523-6477

NPI assigned

Jun 9, 2015

Organization subpart

No

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

Authorized official

Name

Dr. William P Wilson III, MDNPI 1447368758

Title

Owner

Phone

(208) 524-4381

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• William P.D. Wilson III, M.D.

  • Plastic Surgery Physician
  • Idaho Falls, ID
  • NPI 1447368758

  Surgery of the Hand

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1457732000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2860 CHANNING WAY STE 112",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047532",
            "telephone_number": "208-524-4381",
            "fax_number": "208-523-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 CHANNING WAY STE 112",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047532",
            "telephone_number": "208-524-4381",
            "fax_number": "208-523-6477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM WILSON MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-09",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-524-4381",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "ID",
            "license": "M 5527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Wilkins
• Jed Burke Willardson, PA
• Shellie Willardson
• Kendall Craig Willden, O.D.
• Jesse Wille
• Whitney Williams Dutton, LPC
• Williams Hearing, Inc.
• James T Williams
• Jonathan Keith Williams, NP
• Joshua Trevor Williams, FNP-C

• Surgery of the Hand (Plastic Surgery) Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Surgery of the Hand (Plastic Surgery) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.