National Provider Identifier
Donald Robert Wilson, OD
Donald Robert Wilson, OD is listed in the NPPES registry with a primary specialty of Optometrist in Newark, NY and a listed phone number of (315) 331-7917.
Profile Overview
- NPI
- 1023104239
- Provider Type
- Individual
- Primary Specialty
- Optometrist
- Enumeration Date
- October 05, 2006
- Last Updated
- July 08, 2007
Practice Location
- 117 E Union St
- Newark, NY 14513-1503
Phone: (315) 331-7917
Mailing Address
- 88 Matthew Dr
- Fairport, NY 14450-9337
Specialties
- Optometrist (152W00000X)
Full Record
- NPI
- 1023104239
- Entity Type
- Individual
- Last Name
- Wilson
- First Name
- Donald
- Middle Name
- Robert
- Name Prefix
- Dr.
- Credential
- OD
- Mailing Street Address
- 88 Matthew Dr
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450-9337
- Mailing Country
- US
- Mailing Phone
- (585) 223-3412
- Practice Street Address
- 117 E Union St
- Practice City
- Newark
- Practice State
- NY
- Practice ZIP Code
- 14513-1503
- Practice Country
- US
- Practice Phone
- (315) 331-7917
- Enumeration Date
- October 05, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Optometrist (152W00000X)
- Other Identifiers
- 000914282002 (NY, Health Now), 00468644 (NY), 010003598 (NY, Blue Choice), 101949CS (NY, Preferred Care), 020003598 (NY, Blue Cross Blue Shield)