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Contact Information

BRADLEY C WILSON
2807 MONTCLAIR AVE
PASCAGOULA, MS39567-5287
 Phone: 910-382-5414
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Independent Duty Corpsman

1710I1002X
Indicates primary specialty

NPI Profile & details for BRADLEY C WILSON · (Male)

NPI # 1235519984
Status Active
Credentials
Entity Individual
Enumeration date 06/08/2015
Last updated 06/08/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers Not Available
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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