NPIMap

Organization Active NPI

Marble Mountain Health

  • Internal Medicine Physician
  • Fort Jones, CA
National Provider Identifier
1568639615
Registry record updated May 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MARBLE MOUNTAIN HEALTH
Practice address
11219 N Highway 3
Fort Jones, CA 96032-9731
Phone
(530) 468-5766
Fax
(530) 468-2023
NPI assigned
May 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2008

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

Authorized official

Name
Dr. David Phillip Wilson, M.D.NPI 1801891130
Title
Owner/Physician
Phone
(530) 468-5766

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Obstetrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0000X

Addresses

Primary practice location

11219 N Highway 3
Fort Jones, CA 96032-9731

Mailing address

11219 N Highway 3
Fort Jones, CA 96032-9731
Phone (530) 468-5766

National Provider Directory

National Provider Directory

Locations

11219 N State Highway 3
Fort Jones, CA 96032
Phone (530) 468-5766

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210204800000",
    "number": "1568639615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11219 N HIGHWAY 3",
            "city": "FORT JONES",
            "state": "CA",
            "postal_code": "960329731",
            "telephone_number": "530-468-5766",
            "fax_number": "530-468-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11219 N HIGHWAY 3",
            "city": "FORT JONES",
            "state": "CA",
            "postal_code": "960329731",
            "telephone_number": "530-468-5766",
            "fax_number": "530-468-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARBLE MOUNTAIN HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-05-08",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "530-468-5766",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Jones, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2008; 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.