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John Benjamin Wilson

Emergency Medicine

Allopathic & Osteopathic Physicians

1872 Riverside Cir, Easton, PA 18045-5669

PECOS Enrollment

This provider is enrolled in PECOS as JOHN WILSON.

Based on the most recent information from CMS, provider John Benjamin Wilson is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1942520911
Provider Type
Individual
Full Name
Wilson, John Benjamin
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
6/1/2010
Last Updated
6/26/2014

Contact Information

Practice Location

1872 Riverside Cir, Easton, PA 18045-5669

(484) 503-1201

Unlisted Fax

Mailing Location

1872 Riverside Cir, Easton, PA 18045-5669

(484) 503-1201

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 207P00000X Primary	Description Emergency Medicine Allopathic & Osteopathic Physicians	License MD446902 Pennsylvania

John Benjamin Wilson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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