MARK WILSON (NPI# 1518313089) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1710I1003X |
Military Health Care Provider Specialization: Independent Duty Medical Technicians |
Other Service Providers |
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 |
Street Address |
1101 GRADE LN 123 SPECIAL TACTICS |
City | LOUISVILLE |
State | KY |
Zip Code | 40213-2673 |
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 Code | 1710I1003X |
Grouping | Other Service Providers |
Classification | Military Health Care Provider |
Specialization | Independent Duty Medical Technicians |
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] |
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 |
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 |
City | LOUISVILLE |
Zip Code | 40213 |
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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.