DR. KEITH A WILSON (NPI# 1164424743) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164424743 |
| Entity Type | Individual |
| Full Name | DR. KEITH A WILSON |
| Credential | M.D. |
| Practice Address |
10 Dutton Dr Youngstown OH 44502-1818 |
| Practice Telephone | 3307467691 |
| Practice Fax Number | 3307438368 |
| Mailing Telephone | 3307467691 |
| Mailing Fax Number | 3307438368 |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2016-02-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | 35-052784 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | KEYSTONE | 438220 | 01 |
| OH | ANTHEM | 000000126322 | 01 |
| OH | UNITED HEALTHCARE | 0800328 | 01 |
| OH | RAILROAD MEDICARE | 180011155 | 01 |
| OH | AETNA | 4096251 | 01 |
| WV | MEDICAID | 0095849000 | 01 |
| OH | 0624695 | 05 | |
| OH | QUALCHOICE | 82799 | 01 |
| OH | SUMMACARE | Z52784 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982949988 | Keith L Wilson IIi | Counselor | 1330 E Cherry St # 12, Springfield, MO 65802-3429 | 2012-12-01 |
| 1467604744 | Keith C Wilson | Specialist/Technologist, Other | 2503 Robin Knoll Ct, Fresno, TX 77545-8167 | 2008-10-16 |
| 1609022219 | Keith Raymond Wilson | Counselor | 1596 Monroe Ave, Rochester, NY 14618-1415 | 2008-08-14 |
| 1346391976 | Keith Peter Wilson | Dentist | 211 N Second St, Po 727, Peotone, IL 60468-8837 | 2007-01-12 |
| 1578621769 | Keith Jonathan Wilson | Dentist | 10590 Enduring Freedom Dr, Us Army Dental Activity, Fort Drum, NY 13602-5005 | 2006-12-04 |
| 1205907615 | Keith Wilson | Chiropractor | 1717 Amwell Road, Somerset, NJ 08873 | 2006-11-10 |
| 1609307560 | Keith Wilson | Counselor | 8915 Sw Center St, Tigard, OR 97223-6307 | 2017-03-22 |
| 1851732697 | Keith Wilson | Prosthetic/Orthotic Supplier | 1823 Charlotte Ave, Nashville, TN 37203-2104 | 2013-07-09 |
| 1255776258 | Keith Garnett Wilson | Emergency Medicine | 155 N Fresno St, Fresno, CA 93701 | 2013-05-03 |
| 1720248198 | Keith D Wilson Jr. | General Practice | 11722 Reisterstown Rd, Reisterstown, MD 21136-3302 | 2008-06-10 |
| Street Address |
10 DUTTON DR |
| City | YOUNGSTOWN |
| State | OH |
| Zip Code | 44502-1818 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235131913 | Sergul A Erzurum | Ophthalmology | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2005-08-12 |
| 1053639161 | Sarah B Smith | Ophthalmology | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2010-05-13 |
| 1427174382 | Eye Care Associates, Inc. | Eyewear Supplier (Equipment, not the service) | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2007-03-22 |
| 1003909094 | Chad Aaron Shultz | Optometrist | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2006-10-02 |
| 1932132818 | Thomas Michael Grischow | Optometrist | 10 Dutton Dr, Suite 200, Youngstown, OH 44502-1818 | 2006-07-07 |
| 1447203088 | Eye Care Associates, Inc | Optometrist | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2006-05-17 |
| 1184607137 | William George Bartolovich | Optometrist | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2005-11-23 |
| 1760476238 | Guy Claude Barrett | Optometrist | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2005-09-09 |
| 1316949803 | John P Aey | Ophthalmology | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2005-08-15 |
| 1134121577 | Richard E Wyszynski | Ophthalmology | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2005-08-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484189 | Kyle Dalton Flora | Specialist/Technologist | 577 5th Ave Rm 1103, Youngstown, OH 44502 | 2020-07-09 |
| 1700449568 | Lil Indian's Mobile Meals LLC | Meals | 3662 Loveland Rd., Youngstown, OH 44502 | 2019-04-17 |
| 1588155162 | Luke Cantin | Specialist/Technologist | 577 5th Ave, Youngstown, OH 44502 | 2018-05-19 |
| 1104377464 | Jessica Slaughter | Physical Therapist | 299 Edward Street, Youngstown, OH 44502 | 2016-10-20 |
| 1295147585 | Willow Claims Processing, LLC | Case Management | 507 Oak Hill Avenue, 551 New Court, Youngstown, OH 44502 | 2014-05-21 |
| 1821413717 | Amy Woodford | Speech-Language Pathologist | 50 Essex Street, Youngstown, OH 44502 | 2014-02-28 |
| 1710318282 | Ursuline Center | Clinic/Center | 345 Oak Hill Ave Ste 200, Youngstown, OH 44502 | 2013-12-09 |
| 1275891087 | Michael K Lemaster | Counselor | 4949 Urbana Road, Suite 201, Springfield, OH 44502 | 2012-04-30 |
| 1407027378 | Youngstown City Health District | Internal Medicine | 345 Oak Hill Avenue, Youngstown, OH 44502 | 2008-03-18 |
| 1427136431 | Rebecca Ann Nelis | Social Worker | 611 Belmont Avenue, Youngstown, OH 44502 | 2006-11-01 |
| Find all providers in zip 44502 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265540447 | Gerald S. Sevachko, M.d., Inc. | Ophthalmology | 7422 Southern Blvd, Youngstown, OH 44512-5629 | 2006-08-28 |
| 1023087806 | Sherif I Hanna | Ophthalmology | 3020 Belmont Ave, Youngstown, OH 44505-1846 | 2006-03-15 |
| 1235131913 | Sergul A Erzurum | Ophthalmology | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2005-08-12 |
| 1164428199 | Kong T Oh | Ophthalmology | 8110 Market St, Youngstown, OH 44512-6243 | 2005-06-23 |
| 1790781722 | Tac Zhun Lee | Ophthalmology | 8135 Market St, Youngstown, OH 44512-6244 | 2005-06-23 |
| 1053639161 | Sarah B Smith | Ophthalmology | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2010-05-13 |
| 1023187630 | Lee Eye Center Inc | Ophthalmology | 8135 Market St, Youngstown, OH 44512-6244 | 2006-11-07 |
| 1710063540 | Eye Care Associates, Inc. | Ophthalmology | 3155 Canfield Rd, Youngstown, OH 44511-2880 | 2006-10-27 |
| 1316949803 | John P Aey | Ophthalmology | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2005-08-15 |
| 1134121577 | Richard E Wyszynski | Ophthalmology | 10 Dutton Dr, Youngstown, OH 44502-1818 | 2005-08-15 |
| Find all providers in YOUNGSTOWN | ||||
| City | YOUNGSTOWN |
| Zip Code | 44502 |
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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.