DR. JACK COOK WILSON M.D. NPI 1518941517

NPI Information

  • NPI: 1518941517
  • Provider Name: DR. JACK COOK WILSON, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: 612 E 9TH ST
    MOUNTAIN HOME, AR
    ZIP 72653
  • Phone: (870) 424-3652

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NPI Details

DR. Jack Cook Wilson, M.D. is a family medicine in Mountain Home, AR. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Jack Cook Wilson, M.D. NPI is 1518941517. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

612 E 9TH ST
MOUNTAIN HOME, AR
ZIP 72653-804
Phone: (870) 424-3652

The enumeration date for this NPI number is 12/2/2005 and was last updated on 7/9/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineC3223ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
155740MEDICARE ID-TYPE UNSPECIFIEDARKANSASMEDICARE
2D17189MEDICARE UPINARKANSAS
316022000000OTHERARKANSASQUALCHOICE PROVIDER ID #
455740OTHERARKANSASBLUE CROSS BLUE SHIELD ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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