Individual
DR. JACK T WILSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
12010 SHELBYVILLE RD, SUITE 200, LOUISVILLE, KY 40243-1054
(502) 583-4771
(502) 584-9922
Mailing address
12010 SHELBYVILLE RD, SUITE 200, LOUISVILLE, KY 40243-1054
(502) 583-4771
(502) 584-9922
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5247
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5247
DENTIST - GENERAL PRACTIT
KY
Enumeration date
02/21/2007
Last updated
07/08/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us