Active NPI
Robert W Wilson, MD
- Emergency Medicine Physician
- Tulsa, OK
National Provider Identifier
1881667210
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 11833
- Practice address
- 10318 S Hudson Ave
Tulsa, OK 74137-6074 - Phone
- (918) 520-6063
- NPI assigned
- Feb 8, 2006
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 11833 | OK | Primary |
Addresses
Primary practice location
10318 S Hudson Ave
Tulsa, OK 74137-6074
Mailing address
PO Box 5358
Norman, OK 73070-5358
Phone (866) 321-8433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100095070C | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11833 | OK | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southcrest Emergency Physicians PC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Emergency Medical Services (Emergency Medicine) Physician
- Tulsa, OK
- NPI 1205816048
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493942400000",
"number": "1881667210",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5358",
"city": "NORMAN",
"state": "OK",
"postal_code": "730705358",
"telephone_number": "866-321-8433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10318 S HUDSON AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741376074",
"telephone_number": "918-520-6063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ROBERT",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-08",
"last_updated": "2017-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OK",
"license": "11833",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100095070C",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.