Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Mark Wilson

Individual provider Clinic/Center · NPI 1750736088

Mr. Mark Wilson is a Clinic/Center in Philadelphia, Pennsylvania. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2016
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Practice location Address checks out

5313 Ogden St
Philadelphia, PA 19139-1438
Phone: (215) 600-9477
Fax: (215) 921-8499
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinic/Center (primary) Taxonomy 261Q00000X · Licence A-6418104 (PA)

Record details

NPI number1750736088
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 23, 2016
Last updated in NPPESApril 23, 2016

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