David Wilson (NPI# 1376705038, PAC ID# 0042525271) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is MAXILLOFACIAL SURGERY.
| Nation Provider ID (NPI) | 1376705038 |
| PAC ID by PECOS | 0042525271 |
| Professional Enrollment ID | I20150818004444 |
| Full Name | David Wilson |
| Organization Legal Name | KALAMAZOO ORAL AND MAXILLOFACIAL SURGERY PC |
| Address |
4019 W Main St Suite 200 Kalamazoo MI 49006-2798 |
| Phone Number | 2693885898 |
| Gender | M |
| Medical School | UNIVERSITY OF MICHIGAN MEDICAL SCHOOL |
| Graduation Year | 2014 |
| Primary Specialty | MAXILLOFACIAL SURGERY |
| Secondary Specialties | ORAL SURGERY |
| Group Practice PAC ID | 5092994384 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230017 | BRONSON METHODIST HOSPITAL |
| 100128 | TAMPA GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 4019 W Main St, Suite 200, Kalamazoo, MI 49006-2798 | 2693885898 | KALAMAZOO ORAL AND MAXILLOFACIAL SURGERY PC |
| 3801 Glenkerry Ct, Portage, MI 49024-0718 | 2693231527 | KALAMAZOO ORAL AND MAXILLOFACIAL SURGERY PC |
| Organization Legal Name | KALAMAZOO ORAL AND MAXILLOFACIAL SURGERY PC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin D Morse | Oral Surgery | Kalamazoo Oral and Maxillofacial Surgery PC | 3801 Glenkerry Ct, Portage, MI 49024-0718 |
| Thomas A Slack | Maxillofacial Surgery | Kalamazoo Oral and Maxillofacial Surgery PC | 3801 Glenkerry Ct, Portage, MI 49024-0718 |
| Christian L Kanar | Maxillofacial Surgery | Kalamazoo Oral and Maxillofacial Surgery PC | 3801 Glenkerry Ct, Portage, MI 49024-0718 |
| Street Address |
4019 W MAIN ST SUITE 200 |
| City | KALAMAZOO |
| State | MI |
| Zip | 49006-2798 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Deborah E Search Willoughby | Clinical Social Worker | 1410 Turwill Ln, Kalamazoo, MI 49006-1931 | |
| Christine M Roach-brown | Clinical Social Worker | 1410 Turwill Ln, Kalamazoo, MI 49006-1931 | |
| Tatjana Maric | Psychiatry | Pine Rest Christian Mental Health Services | 1530 Nicholas Rd, Kalamazoo, MI 49006-2065 |
| Ronald J De Vries | Psychologist, Clinical | Pine Rest Christian Mental Health Services | 1530 Nichols Rd, Pine Rest Kalamazoo Clinic, Kalamazoo, MI 49006-2065 |
| Alberto R Rivera Gutierrez | Psychiatry | Pine Rest Christian Mental Health Services | 1530 Nicholas Rd, Kalamazoo, MI 49006-2065 |
| Shannon L Thompson | Clinical Social Worker | Pine Rest Christian Mental Health Services | 1530 Nicholas Rd, Kalamazoo, MI 49006-2065 |
| Randall Estes | Clinical Social Worker | Pine Rest Christian Mental Health Services | 1530 Nicholas Rd, Kalamazoo, MI 49006-2065 |
| Karin A Kennedy | Clinical Social Worker | Pine Rest Christian Mental Health Services | 1530 Nicholas Rd, Kalamazoo, MI 49006-2065 |
| Susanne L Boyd | Physician Assistant | Pine Rest Christian Mental Health Services | 1530 Nicholas Rd, Kalamazoo, MI 49006-2065 |
| Sarah K Christian | Clinical Social Worker | Pine Rest Christian Mental Health Services | 1530 Nicholas Rd, Kalamazoo, MI 49006-2065 |
| Find all physicians in zip 49006 | |||
| City | KALAMAZOO |
| Zip Code | 49006 |
| Specialty | MAXILLOFACIAL SURGERY |
| City + Specialty | KALAMAZOO + MAXILLOFACIAL SURGERY |
Please comment or provide details below to improve the information on David Wilson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.