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Contact Information

THOMAS A WILSON, MD
1010 MURRAY AVE
SAN LUIS OBISPO, CA93405-1806
 Phone: 805-546-7692
 Fax: 805-546-7932
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Endocrinology

2080P0205X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for THOMAS A WILSON · (Male)

NPI Number 1063454080
Status Active
Credentials MD
Entity Individual
Enumeration date 06/12/2006
Last updated 05/19/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • CA License # G30444
  • NY License # 151531
  • NY Medicaid 00725544
  • NY Other 4249553 AETNA
  • NY Other 79A002 EMPIRE BC.BS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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