MARK WILSON


Address: 1101 Grade Ln, 123 Special Tactics, Louisville, KY 40213-2673
Phone: 5024134836

MARK WILSON (NPI# 1518313089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518313089
Entity Type Individual
Full Name MARK WILSON
Other Name MR. MARK ALLEN WILSON
Credential IDMT
Practice Address 1101 Grade Ln
123 Special Tactics
Louisville
KY 40213-2673
Mailing Address 2200 Mammoth Way
Louisville
KY 40299-2611
Practice Telephone 5024134836
Mailing Telephone 5024721274
Enumeration Date 2016-05-13
Last Update Date 2016-05-13
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Other Providers MARK WILSON

NPI Name Taxonomy Address Enumeration
1750736088 Mark Wilson Clinic/Center 5313 Ogden St, Philadelphia, PA 19139-1438 2016-04-23
1992123285 Mark Wilson Occupational Therapist 2820 Roosevelt Road Ste 105, San Diego, CA 92106 2014-04-03
1053611699 Mark Leo Wilson Pharmacist 5049 S 13th St, Leavenworth, KS 66048-5581 2010-10-29
1003132754 Mark Davis Wilson Pediatrics 1909 Us Highway 82 W Ste 3&4, Tifton, GA 31793 2010-04-19
1013076405 Mark R Wilson Acupuncturist 11573 Los Osos Valley Rd Ste H, San Luis Obispo, CA 93405-6497 2006-12-08
1700950771 Mark Wilson Chiropractor 2300 Great Northern Ave Ste B, Missoula, MT 59808-1726 2006-11-20
1578633046 Mark K Wilson Dentist 107 N Maple, Osceola, AR 72370 2006-11-09
1437239357 Mark A. Wilson Dentist 400 Duncan Station Rd, Mckeesport, PA 15135-3333 2006-10-16
1831287267 Mark S Wilson Anesthesiology 4444 Corona Dr Ste 215, Corpus Christi, TX 78411-4300 2006-10-11
1679660682 Mark Wilson Emergency Medicine 2801 Franciscan Drive, St. Joseph's Regional Health System- Emergency Dept., Bryan, TX 77802 2006-10-10

Office Location

Street Address 1101 GRADE LN
123 SPECIAL TACTICS
City LOUISVILLE
State KY
Zip Code 40213-2673

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1487130076 Latonia Cheeks Counselor 4835 Poplar Level Rd Ste. 110, Louisville, KY 40213 2018-07-17
1225553431 Kandace Ratterman Case Manager/Care Coordinator 4814 Kingfisher Way, Louisville, KY 40213 2017-08-08
1700338456 Ann Devos Physician Assistant 3303 Fern Valley Road, Louisville, KY 40213 2016-10-28
1124426275 Rebecca Sue Jenkins Home Health Aide 3523 Whippoorwill Rd, Louisville, KY 40213 2014-12-05
1053518308 Gabor Ambrus Pathology 4500 Conaem Drive, Louisville, KY 40213 2007-06-29
1760504724 Benjamin Francis Robinson Chiropractor 4919h Dixie Highway, Louisville, KY 40213 2007-04-03
1790814408 Howard L Green Dentist 3813 Poplar Level Rd, Louisville, KY 40213 2007-03-06
1063587970 Roy Hyman Optometrist 5202 Preston Hwy, Louisville, KY 40213 2006-11-24
1689769291 James H Kidwell Psychologist 1448 Gardiner Lane, Suite 202 203, Louisville, KY 40213 2006-10-03
1366556524 Harris & Harris Dmd Psc Dentist 5014 Preston Hwy, #b, Louisville, KY 40213 2006-08-17
Find all providers in zip 40213

Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Notes: Source: Air Force Surgeon General Office [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1497001044 Paul K Vought Military Health Care Provider 9223 Rainbow Springs Ct Apt 5, Louisville, KY 40241-2249 2012-08-01
1558845362 Walter Buckner Military Health Care Provider 420 Post Ave, Louisville, TN 37777-6223 2018-09-18
1104052216 Jack Homer Atkins IIi Military Health Care Provider 420 Post Ave, Louisville, TN 37777-6223 2009-06-03
1811123128 Glen Robert Riley Military Health Care Provider 420 Post Ave, Louisville, TN 37777-6223 2009-06-02

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1982239869 William Caleb Flaspoehler Military Health Care Provider 3360 Kami Dr, Bowling Green, KY 42104-4636 2020-03-11
1124361399 Jeffrey Allen Marr Military Health Care Provider 477 Top Hill Rd, Brandenburg, KY 40108-9499 2013-04-05

Competitor

Search similar providers

City LOUISVILLE
Zip Code 40213

Improve Information

Please comment or provide details below to improve the information on MARK WILSON.

Dataset Information

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.

Trending Searches