Thomas A Wilson, MD | |
2478 13th St Se, Salem, OR 97302-2546 | |
(503) 362-2481 | |
(503) 371-7803 |
Full Name | Thomas A Wilson |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 2478 13th St Se, Salem, Oregon |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1679567085 | NPI | - | NPPES |
241166 | Medicaid | OR |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | MD121816 (Oregon) | Secondary |
208000000X | Pediatrics | MD12816 (Oregon) | Primary |
Entity Name | Salem Pediatric Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245307693 PECOS PAC ID: 2961497003 Enrollment ID: O20040417000344 |
Mailing Address | Practice Location Address |
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Thomas A Wilson, MD 2478 13th St Se, Salem, OR 97302-2546 Ph: (503) 362-2481 | Thomas A Wilson, MD 2478 13th St Se, Salem, OR 97302-2546 Ph: (503) 362-2481 |
Suzanne Mcclintick, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 891 23rd St Ne, Salem, OR 97301 Phone: 503-364-2181 Fax: 503-364-0364 | |
Dr. Kimberly Ann Heggen, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 891 23rd St Ne, Salem, OR 97301 Phone: 503-364-2181 Fax: 503-364-0364 | |
Dr. Paige Frances Tomes, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1233 Edgewater St Nw, Salem, OR 97304 Phone: 503-378-7526 Fax: 503-480-1611 | |
Rachael Hiebert, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2478 13th St Se, Salem, OR 97302 Phone: 503-362-2481 Fax: 503-375-8700 | |
Dr. Michael Adam Marlowe, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 5125 Skyline Rd S, Salem, OR 97306 Phone: 503-361-5400 | |
Jenny Sue Wing Hoelter, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 891 23rd St Ne, Childhood Health Associates Of Salem, Salem, OR 97301 Phone: 503-364-2181 | |
Bryan Scott Child, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 890 Oak St Se, Salem, OR 97301 Phone: 509-987-6774 |