MR. DALE RICHARD WILSON JR. (NPI# 1154741080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154741080 |
| Entity Type | Individual |
| Full Name | MR. DALE RICHARD WILSON JR. |
| Credential | PA-C |
| Practice Address |
1721 Admiral Taussig Blvd Norfolk VA 23511-2802 |
| Practice Telephone | 7579539000 |
| Enumeration Date | 2014-04-18 |
| Last Update Date | 2014-04-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306172630 | Dale Curtis Wilson | Chiropractor | 21 E 58th St, Brooklyn, NY 11203-3711 | 2009-10-21 |
| 1619537321 | Dale Wilson | Counselor | 2035 Fairmont Dr, San Leandro, CA 94578-1088 | 2019-06-14 |
| 1891051314 | Dale G Wilson | Surgery | 1100 Goethals Dr Ste E, Richland, WA 99352-3301 | 2012-04-10 |
| 1982901435 | Dale Wilson | Counselor | 411 N Allumbaugh St, Boise, ID 83704-9210 | 2011-02-18 |
| 1578714481 | Dale Wilson | Pharmacist | 2250 Hickory Rd, Suite 240, Plymouth Meeting, PA 19462-1047 | 2008-10-09 |
| 1235328667 | Dale A Wilson | Obstetrics & Gynecology | 2521 N Elms Rd, Flushing, MI 48433-9426 | 2007-10-22 |
| 1013943968 | Dale F Wilson | Anesthesiology | 595 W State St, Doylestown, PA 18901-2554 | 2006-06-23 |
| Street Address |
1721 ADMIRAL TAUSSIG BLVD |
| City | NORFOLK |
| State | VA |
| Zip Code | 23511-2802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588635072 | Alexander Royzenblat | Dentist | 1721 Admiral Taussig Blvd, Sewell's Point Branch Medical Clinic, Norfolk, VA 23511-2802 | 2006-02-01 |
| 1558877878 | Ismael Arturo Lopez | Military Health Care Provider | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2017-12-22 |
| 1184133670 | Jeffrey Joseph Illinik | Physician Assistant | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2017-09-27 |
| 1629525837 | Matthew Squires | Optometrist | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2016-09-06 |
| 1144775529 | Volha Zarubina Just | Physician Assistant | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2016-08-16 |
| 1891141768 | Itse Begho | Student in an Organized Health Care Education/Training Program | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2016-05-10 |
| 1134581176 | Damico Hill | Physician Assistant | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2016-03-28 |
| 1295194157 | David Barclay England II | Psychologist | 1721 Admiral Taussig Blvd, Department of Mental Health, Norfolk, VA 23511-2802 | 2016-02-19 |
| 1164808598 | Justin Michael Loder | Physician Assistant | 1721 Admiral Taussig Blvd, Norfolk, VA 23511-2802 | 2015-08-07 |
| 1548645179 | Julie Simmons | Optometrist | 1721 Admiral Taussig Blvd, Optometry, Norfolk, VA 23511-2802 | 2015-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215591888 | Nash Richard Galvan | Military Health Care Provider | 456-462 Pocahontas St, Norfolk, VA 23511 | 2019-04-29 |
| 1578059481 | Hillary Anne Diffee | Dentist | Navsta Norfolk Sewells Point Branch Clinic, 1647 Admiral Taussig Blvd, Norfolk, VA 23511 | 2018-07-03 |
| 1154860237 | Alexander Blau | General Practice | 1751 Morris Street, Comnavsurflant - Medical Readiness Division, Norfolk, VA 23511 | 2017-02-22 |
| 1205188307 | Agnes Bautista Banias | Dental Hygienist | 1647 Admiral Taussig Blvd Br Health Clinic, Naval Medical Center Portsmouth, Norfolk, VA 23511 | 2012-10-12 |
| 1891052676 | Conor Francis Hynes | Surgery | 1530 Gilbert St Ste 2000, Norfolk, VA 23511 | 2012-04-18 |
| 1871867747 | Brian Joseph Kennerley | Surgery | U. S. Marine Corps Forces Command, 1775 Forrestal Drive Bldg 33, Norfolk, VA 23511 | 2012-02-23 |
| 1053629964 | Shawnly Heath Ward | Military Health Care Provider | Surface Warfare Medical Institute - East, 459 Bellinger Blvd, Norfolk, VA 23511 | 2010-09-14 |
| 1225351760 | Jocelyn Martinezdelgado | Military Health Care Provider | 8857 1st Street, Pcu Jason Dunham Suite 400, Norfolk, VA 23511 | 2010-03-11 |
| 1245480854 | Vanessa O Hofilena | Dentist | 1647 Admiral Taussig Boulevard, Naval Medical Center Portsmouth - Dental Center, Norfolk, VA 23511 | 2008-09-19 |
| 1780833954 | Cecilia M Brownblake | Dentist | 1647 Admiral Taussig Blvd., Norfolk, VA 23511 | 2008-09-12 |
| Find all providers in zip 23511 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184434 | Jacob Solomon Morrill | Physician Assistant | 2701 W Norfolk Ave Fl 4, Norfolk, NE 68701-4407 | 2020-11-07 |
| 1558990291 | Ellen Marie Pagliarulo | Physician Assistant | 21 Ridge Rd, Norfolk, MA 02056-1748 | 2020-04-04 |
| 1437785870 | Marissa Knott | Physician Assistant | 7509 Honeysuckle Rd, Norfolk, VA 23518-4514 | 2020-03-17 |
| 1700428349 | Sydney Charmagne Pawsey | Physician Assistant | 601 Pembroke Ave Apt 610, Norfolk, VA 23507-2051 | 2019-10-15 |
| 1831730944 | Brittany Anne Porter | Physician Assistant | 1362 Virgilina Ave, Norfolk, VA 23503-2218 | 2019-10-01 |
| 1437626686 | Kayla Sommers | Physician Assistant | 601 Childrens Ln Fl 2, Norfolk, VA 23507-1910 | 2018-10-25 |
| 1821573593 | Giselle Castaneda De Guzman | Physician Assistant | 400 W Brambleton Ave Ste 104, Norfolk, VA 23510-1151 | 2018-09-28 |
| 1093297103 | Nicole Marie Owens | Physician Assistant | 2701 W. Norfolk Ave, Norfolk, NE 68701 | 2018-09-05 |
| 1265925150 | Emily Burke | Physician Assistant | 171 Kempsville Rd Ste 200, Norfolk, VA 23502-4700 | 2018-06-14 |
| 1124546163 | Jonathan Joseph Daly | Physician Assistant | 171 Kempsville Rd Bldg A2nd, Norfolk, VA 23502-4700 | 2017-08-30 |
| Find all providers in NORFOLK | ||||
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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.