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Contact Information

JEFFERY J WILSON
200 E STATE ST FL 3
ALLIANCE, OH44601
 Phone: 330-821-8503
 Fax: 330-627-0088
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for JEFFERY J WILSON · (Male)

NPI Number 1023597135
Status Active
Credentials
Entity Individual
Enumeration date 08/09/2018
Last updated 11/14/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • OH License # CDCA172080
  • OH Medicaid 0319802
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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