Active NPI
Eric Wilson, MD
- Surgery Physician
- Oklahoma City, OK
National Provider Identifier
1518560010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 41484
- Practice address
- 800 Stanton L Young Blvd
Aat 9432
Oklahoma City, OK 73104-5018 - Phone
- (405) 271-6308
- NPI assigned
- Nov 17, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 41484 | OK | Primary |
Addresses
Primary practice location
800 Stanton L Young Blvd
Aat 9432
Oklahoma City, OK 73104-5018
Mailing address
800 Stanton L Young Blvd
Aat 9432
Oklahoma City, OK 73104-5018
Phone (405) 271-6308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230830000530 | OK | Order and Referring Only - General Surgery | 3971966557 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1605571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1518560010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 STANTON L YOUNG BLVD",
"address_2": "AAT 9432",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045018",
"telephone_number": "405-271-6308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 STANTON L YOUNG BLVD",
"address_2": "AAT 9432",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045018",
"telephone_number": "405-271-6308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ERIC",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-11-17",
"last_updated": "2023-06-15",
"certification_date": "2023-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "OK",
"license": "41484",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.