THOMAS CHARLES WILSON (NPI# 1679538565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679538565 |
| Entity Type | Individual |
| Full Name | THOMAS CHARLES WILSON |
| Credential | DC |
| Practice Address |
213 State St W Detroit Lakes MN 56501-3005 |
| Practice Telephone | 2188474366 |
| Practice Fax Number | 2188471838 |
| Mailing Telephone | 2188474366 |
| Mailing Fax Number | 2188471838 |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2010-02-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 001629 | MN | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS/BLUE SHIELD | 49403WI | 01 |
| MN | 972327700 | 05 | |
| MN | CHIROPRACTIC CARE OF MN | 410144 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518287945 | Thomas A Wilson | Dentist | 149 Midland Ave, Bronxville, NY 10708-1808 | 2010-06-08 |
| 1568790186 | Thomas E. Wilson | Dentist | Bldg 128 Chaffee Rd, Us Army Dental Activit, Fort Bliss, TX 79916 | 2009-11-19 |
| 1487884375 | Thomas Joseph Wilson | Dentist | 8401 Howland Springs Rd Se, Warren, OH 44484-3120 | 2009-07-26 |
| 1891922951 | Thomas Cary Wilson | Pathology | 5330 S 900 E Ste 120, Salt Lake City, UT 84117-3504 | 2009-06-16 |
| 1609080183 | Thomas Cabell Wilson | General Practice | 323 Crescent Rd, Beckley, WV 25801 | 2007-05-10 |
| 1881817625 | Thomas Gregory Wilson | Dentist | 105 South Porter Street, Bolivar, TN 38008-1734 | 2007-04-10 |
| 1104901107 | Thomas Wayne Wilson | Dentist | 484 Jake Alexander Blvd W, Salisbury, NC 28147-1365 | 2006-10-26 |
| 1285716324 | Thomas Anthony Wilson Jr. | Counselor | 514 S Orchard St, Suite 101, Boise, ID 83705-1240 | 2006-10-19 |
| 1558443432 | Thomas E Wilson | Pathology | 1500 East Medical Center, 2nd Floor University Hospital Recp Pathology, Ann Arbor, MI 48109-5054 | 2006-10-19 |
| 1821101585 | Thomas William Wilson | Pharmacist | 7128 E Reno Ave, Suite A, Midwest City, OK 73110-4478 | 2006-08-16 |
| Street Address |
213 STATE ST W |
| City | DETROIT LAKES |
| State | MN |
| Zip Code | 56501-3005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235793886 | Detroit Lakes Chiropractic, PC | Chiropractor | 213 State St W, Detroit Lakes, MN 56501-3005 | 2019-04-30 |
| 1770841405 | Dustin Paul Johnson | Chiropractor | 213 State St W, Detroit Lakes, MN 56501-3005 | 2012-05-01 |
| 1073840492 | Gary A Matthys Md Plc | Orthopaedic Surgery | 213 State St W, Detroit Lakes, MN 56501-3005 | 2009-11-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588265649 | Candace Louise Haugtvedt | Pharmacist | 321 Us-10 West, Detroit Lakes, MN 56501 | 2020-11-05 |
| 1679068407 | Strive Chiropractic Detroit Lakes LLC | Chiropractor | 1852 Nodaway Drive, Detroit Lakes, MN 56501 | 2018-06-25 |
| 1194215830 | Jordan James Reese | Registered Nurse | 1295 Bay Ridge Dr, Detroit Lakes, MN 56501 | 2018-05-17 |
| 1992179386 | Compassion House | Substance Abuse Rehabilitation Facility | 811 8th St. Se, Detroit Lakes, MN 56501 | 2015-11-23 |
| 1720344286 | Lakes Crisis & Resource Center | Clinic/Center | 1339 Pelican Lane, Detroit Lakes, MN 56501 | 2012-04-09 |
| 1063657120 | Diane Jean Mccormack | Occupational Therapist | 15840 Long Lake Road, Detroit Lakes, MN 56501 | 2008-12-03 |
| 1588817928 | Darcy Caleb Olson | Counselor | 925 Lake Ave, Detroit Lakes, MN 56501 | 2008-10-29 |
| 1760651079 | Rapidcare Urgent Care Pllc | Family Medicine | 1361 Wenner Road, Detroit Lakes, MN 56501 | 2008-02-21 |
| 1427274729 | Jeffrey C Gregory | Psychologist | 910 Lincoln Ave, Detroit Lakes, MN 56501 | 2007-04-17 |
| 1144364894 | Midwest Vision Centers Inc | Eyewear Supplier (Equipment, not the service) | 830 Washington Avenue, Detroit Lakes, MN 56501 | 2007-02-16 |
| Find all providers in zip 56501 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679068407 | Strive Chiropractic Detroit Lakes LLC | Chiropractor | 1852 Nodaway Drive, Detroit Lakes, MN 56501 | 2018-06-25 |
| 1427180652 | David William Laudon | Chiropractor | 717 Andrews Ave, Detroit Lakes, MN 56501-2146 | 2007-03-12 |
| 1174672646 | Jonathon Michael Haug | Chiropractor | 1265 Highway 10 W, Suite 9, Detroit Lakes, MN 56501-2236 | 2007-01-10 |
| 1689759383 | Jennifer Elyse Pedersen | Chiropractor | 516 Main Street East, Detroit Lakes, MN 56501 | 2006-10-25 |
| 1831118918 | Weum Chiropractic Clinic Inc | Chiropractor | 1225 Washington Ave, Detroit Lakes, MN 56501 | 2006-07-19 |
| 1437145711 | Lakeland Chiropractic Clinic | Chiropractor | 119 Graystone Plz, Ste 110, Detroit Lakes, MN 56501-3034 | 2005-09-22 |
| 1346236627 | Bender Family Chiropractic Pllc | Chiropractor | 119 Graystone Plaza, Suite 110, Detroit Lakes, MN 56501 | 2005-09-22 |
| 1235793886 | Detroit Lakes Chiropractic, PC | Chiropractor | 213 State St W, Detroit Lakes, MN 56501-3005 | 2019-04-30 |
| 1770841405 | Dustin Paul Johnson | Chiropractor | 213 State St W, Detroit Lakes, MN 56501-3005 | 2012-05-01 |
| 1679760219 | Jay W Johnson | Chiropractor | 1208 Washington Ave, Detroit Lakes, MN 56501-3906 | 2007-09-27 |
| Find all providers in DETROIT LAKES | ||||
| City | DETROIT LAKES |
| Zip Code | 56501 |
Please comment or provide details below to improve the information on THOMAS CHARLES WILSON.
| 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.