DAVID BLAIR WILSON (NPI# 1104464627) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104464627 |
| Entity Type | Individual |
| Full Name | DAVID BLAIR WILSON |
| Credential | R.PH. |
| Practice Address |
100 E Idaho St Boise ID 83712-6267 |
| Mailing Address |
2040 S Ridge Point Way Boise ID 83712-8515 |
| Practice Telephone | 2083817189 |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835X0200X |
Pharmacist Specialization: Oncology |
P4166 | ID | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083828 | David Ephriam Wilson V | Pharmacist | 4099 Red Bluff Rd, Loris, SC 29569-6238 | 2020-11-05 |
| 1265030969 | David Nicholas Wilson | Social Worker | 2419 E Hazzard St, Philadelphia, PA 19125-3112 | 2020-10-14 |
| 1467059527 | David Ray Wilson IIi | Technician | 345 City Ave Apt 1, Beckley, WV 25801-5967 | 2020-10-02 |
| 1609484708 | David Wilson | Technician | 254 Township Road 1110, Proctorville, OH 45669-8437 | 2020-07-15 |
| 1598386856 | David Wilson | Pharmacist | 192 S Dry Creek Ln, Vineyard, UT 84059-5680 | 2020-04-28 |
| 1275982779 | David M. Wilson | Specialist/Technologist | 7510 Madison St, Merrillville, IN 46410-4609 | 2016-06-07 |
| 1609253376 | David Wilson Jr. | Massage Therapist | 2904 Odonnell St, Baltimore, MD 21224-4820 | 2015-05-01 |
| 1992115794 | David Andrew Wilson | Massage Therapist | 1501 E Jefferson St, Seattle, WA 98122-5627 | 2014-05-01 |
| 1184040800 | David Charles Wilson | Counselor | 116 Dumaine Pl, Madison, MS 39110-9234 | 2014-03-06 |
| 1104259167 | David Lawrence Wilson | Counselor | 702 E. Franklin Avenue, Sunnyside, WA 98944-0997 | 2013-08-14 |
| Street Address |
100 E IDAHO ST |
| City | BOISE |
| State | ID |
| Zip Code | 83712-6267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336133776 | Gregory G Janos | Pediatrics | 100 E Idaho St, Suite 200, Boise, ID 83712-6267 | 2005-08-31 |
| 1205444734 | Allison Reed | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-07-21 |
| 1619585247 | Christina Gullion | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-07-20 |
| 1548897556 | Brooke Hueftle | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-03-27 |
| 1194364919 | Sarah Rosemarie Hogue | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-26 |
| 1710525167 | Leslie Lynn Lamontagne | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-17 |
| 1487292843 | Lauren Zupsic | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-17 |
| 1659919199 | Stephanie Matta | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-16 |
| 1386282788 | Jessie Modlin | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-16 |
| 1740828383 | Bryce Benson | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477016012 | Veranda At Barber Station LLC | Assisted Living Facility | 3266 E. Barber Valley Drive, Boise, ID 83712 | 2019-04-10 |
| 1891258612 | Mary Elizabeth Riedel | Occupational Therapist | 190 E Bancock St., Boise, ID 83712 | 2019-04-09 |
| 1427523968 | Q17 Health Partners LLC | Surgery | 100 East Idaho Street #317, Boise, ID 83712 | 2018-10-11 |
| 1053898247 | Travis Dale Worwood | Social Worker | South Entrance, 1075 E. Park Blvd, Boise, ID 83712 | 2018-07-20 |
| 1689166761 | Kristen Nicole Ray | Social Worker | 109 E Bannock St, Boise, ID 83712 | 2018-06-04 |
| 1740706894 | Meghan Heitstuman | Social Worker | 190 E Bannock Street, Boise, ID 83712 | 2017-08-21 |
| 1942759725 | Kay Craig | Physical Therapist | 190 Bannock, Boise, ID 83712 | 2016-09-22 |
| 1235686395 | Sharon Bjornson | Physical Therapist | 190 East Bannack, Boise, ID 83712 | 2016-09-07 |
| 1033576491 | Heather Hussey | Genetic Counselor, MS | 100 E Idaho Street, Msti Genetics, Boise, ID 83712 | 2016-01-15 |
| 1295139137 | Amie Bartholomeus | Massage Therapist | 100 East Idaho Street, St Luke's Mountain States Tumor Institute, Boise, ID 83712 | 2014-10-21 |
| Find all providers in zip 83712 | ||||
| Taxonomy Code | 1835X0200X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Oncology |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in developing, recommending, implementing, monitoring, and modifying pharmacotherapeutic plans to optimize outcomes in patients with malignant diseases. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205444734 | Allison Reed | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-07-21 |
| 1619585247 | Christina Gullion | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2020-07-20 |
| 1194364919 | Sarah Rosemarie Hogue | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-26 |
| 1710525167 | Leslie Lynn Lamontagne | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-17 |
| 1487292843 | Lauren Zupsic | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-17 |
| 1376181743 | Amanda Lorene Wright | Pharmacist | 190 E Bannock St, Boise, ID 83712-6241 | 2019-12-17 |
| 1659919199 | Stephanie Matta | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-16 |
| 1386282788 | Jessie Modlin | Pharmacist | 100 E Idaho St, Boise, ID 83712-6267 | 2019-12-16 |
| 1063050649 | James William Byron | Pharmacist | 190 E Bannock St, Boise, ID 83712-6241 | 2019-12-14 |
| 1023656667 | Julia R Kerr | Pharmacist | 100 E Idaho St Ste 300, Boise, ID 83712-6269 | 2019-12-13 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.