Thomas J Wilson, MD | |
625 East Broadway, St Johns Medical Center Dept Of Radiology, Jackson, WY 83001 | |
(800) 633-1905 | |
(913) 491-0411 |
Full Name | Thomas J Wilson |
---|---|
Gender | Male |
Speciality | Radiology - Diagnostic Radiology |
Location | 625 East Broadway, Jackson, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1689788655 | NPI | - | NPPES |
5596A | Other | WY | MEDICAL LICENSE |
313044 | Other | WYOMING BLUE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2085R0202X | Radiology - Diagnostic Radiology | 5596A (Wyoming) | Primary |
Entity Name | Jackson Hole Medical Imaging Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1669586632 PECOS PAC ID: 0648162339 Enrollment ID: O20040326001277 |
Mailing Address | Practice Location Address |
---|---|
Thomas J Wilson, MD Po Box 9230, Jackson, WY 83002-9230 Ph: (800) 633-1905 | Thomas J Wilson, MD 625 East Broadway, St Johns Medical Center Dept Of Radiology, Jackson, WY 83001 Ph: (800) 633-1905 |
John A. Sullivan, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 7330 Ryegrass Road, Jackson, WY 83001 Phone: 307-733-9105 | |
Richard A Ofstein, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: St Johns Medical Center Dept Of Radiology, 625 E Broadway, Jackson, WY 83011 Phone: 800-633-1905 Fax: 913-491-0411 | |
Christopher Sean Haling, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 625 East Broadway, St Johns Medical Center Dept Of Radiology, Jackson, WY 83001 Phone: 800-633-1905 | |
Katharine A Yoler, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 715 Snow King Dr, Jackson, WY 83001 Phone: 206-755-3545 | |
Robert Paul Jones, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 625 E Broadway Ave, Jackson, WY 83001 Phone: 307-739-7282 | |
Gary W Heath, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 625 East Broadway, St Johns Medical Center Dept Of Radiology, Jackson, WY 83001 Phone: 800-633-1905 |