Donald R. Wilson, M.D., Inc.

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

A24934 Issued in CA

Legal business name

DONALD R. WILSON, M.D., INC.

Practice address

715 Linda Falls Ter
Angwin, CA 94508-9684

Phone

(707) 965-2181

Fax

(707) 965-3576

NPI assigned

Aug 20, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Donald Richard Wilson, M.D.

Title

President

Phone

(707) 965-2181

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1345420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345420800000",
    "number": "1790033959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 714",
            "city": "ANGWIN",
            "state": "CA",
            "postal_code": "945080714",
            "telephone_number": "707-965-2181",
            "fax_number": "707-965-3576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 LINDA FALLS TER",
            "city": "ANGWIN",
            "state": "CA",
            "postal_code": "945089684",
            "telephone_number": "707-965-2181",
            "fax_number": "707-965-3576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD R. WILSON, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-20",
        "last_updated": "2012-08-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "707-965-2181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "A24934",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OOA249340",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI(INDIVIDUAL)",
            "identifier": "127551376",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Angwin, CA
• Providers in Angwin, CA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; 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.