Organization Active NPI

Barry K Wilson MD Inc

  • Anesthesiology Physician
  • Stockton, CA
National Provider Identifier
1790107829
Registry record updated Sep 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
BARRY K WILSON MD INC
Practice address
1801 E March LN
Suite 360
Stockton, CA 95210-6629
Phone
(209) 951-1178
NPI assigned
Jan 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2014

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

Authorized official

Name
Barry K Wilson, MD
Title
Owner
Phone
(209) 951-1178

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

1801 E March LN
Suite 360
Stockton, CA 95210-6629

Mailing address

PO Box 7096
Stockton, CA 95267-0096
Phone (209) 956-7725

National Provider Directory

National Provider Directory

Locations

2288 Auburn Blvd
Sacramento, CA 95821
Phone 916568834443

1801 E March Ln
Ste 360
Stockton, CA 95210
Phone (209) 572-2700

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": "1389139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409788800000",
    "number": "1790107829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7096",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952670096",
            "telephone_number": "209-956-7725",
            "fax_number": "209-956-7733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 E MARCH LN",
            "address_2": "SUITE 360",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952106629",
            "telephone_number": "209-951-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY K WILSON MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-08",
        "last_updated": "2014-09-04",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-951-1178",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; 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.