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Individual

DR. MARK C WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
CHILDREN'S HOSPITAL - RESPIRATORY MEDICINE & ALLERGY, 8200 DODGE STREET, OMAHA, NE 68114-4113
(402) 955-5570
(402) 955-5575
Mailing address
CHILDREN'S HOSPITAL, 8200 DODGE STREET, OMAHA, NE 68114-4113
(402) 955-5400

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
17658
NE
2080P0214X
Pediatric Pulmonology Physician
17658
NE
2080S0012X
Pediatric Sleep Medicine Physician
Primary
17658
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1926246
IA
01
31219
BCBS
NE
01
662
MIDLANDS CHOICE
05
7781510
SD
01
94533
BCBS
IA
Enumeration date
05/16/2006
Last updated
09/11/2025
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