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General NPI Number Information
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NPI Number | 1407808793
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Entity Type | Individual
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Provider Name | MARK C WILSON MD
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | CHILDREN'S HOSPITAL - RESPIRATORY MEDICINE & ALLERGY 8200 DODGE STREET
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City | OMAHA
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State | NE
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Zip | 68114-4113
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Country | US
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Telephone | 402-955-5570
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Fax | 402-955-5575
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Provider Business Mailing Address
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Address Line | CHILDREN'S HOSPITAL 8200 DODGE STREET
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City | OMAHA
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State | NE
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Zip | 68114-4113
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Country | US
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Telephone | 402-955-5400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080S0012X
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Taxonomy Name | Pediatric Sleep Medicine Physician
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License Number | 17658
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 2080P0214X
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Taxonomy Name | Pediatric Pulmonology Physician
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License Number | 17658
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 17658
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License Number State | NE
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