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Deactivated NPI 1275573305 Deactivated / Inactive NPI Male Practitioner

Lonnie Wilson , PA

Physician Assistant • Tyler, TX

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Lonnie Wilson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 07, 2006
NPI Deactivation Date May 21, 2019
Total Practice Duration ~13 Years of Practice (2006 – 2019)

Professional Overview & Biography Verified Profile Summary

Lonnie Wilson, PA was a registered Physician Assistant practicing in Tyler, TX. Throughout an active medical career spanning 13 years, Lonnie Wilson provided care at the practice location at 1000 S BECKHAM AVE until profile deactivation on 2019-05-21.

Practice Location & Contact Primary Location

Practice Address

1000 S Beckham Ave

Tyler, TX 757011908

Telephone 9035970351
Fax 9035925282
Associated Practice Facility / Clinic
🏢 Alex Detwiler, M.d., P.a. Facility NPI 1073601118

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Tyler, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.1 Yrs
State Avg: 13.9 Yrs
Regional Practice Density
99 Specialists

Practicing in Tyler, TX (11140 Statewide)

Telehealth Adoption Rate
6.1% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License TX PA02726

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Mahider Gedamu

Nurse Practitioner - Acute Care

NPI 1033032636
Dr. Jackie Rose , MD

Emergency Medicine

NPI 1073552691

Doctor of Medicine (M.D.)

Jeffrey Barker , CRNA

Nurse Anesthetist, Certified Registered

NPI 1083070072

Certified Registered Nurse Anesthetist

Olivia Langford

Nurse Practitioner - Neonatal

NPI 1083284285
NPI 1093499014
Dr. Caitlin Burns , MD

Student in an Organized Health Care Education/Training Program

NPI 1093565731

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 21, 2019

Record deactivated on May 21, 2019

NPI Profile Active November 02, 2007

NPI status registered as active in NPPES database

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Updated Practice Location November 02, 2007

Registered at 1000 S BECKHAM AVE, TYLER, TX 757011908 (Tel: 9035970351)

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Updated Business Mailing Address November 02, 2007

Registered at PO BOX 6455, TYLER, TX 757116455 (Tel: 9035942451)

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Provider Name / Credentials Updated November 02, 2007

Recorded as LONNIE WILSON, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) November 02, 2007

Physician Assistant (License #PA02726 in TX)

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Initial NPI Registration & Enumeration June 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1275573305
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 07, 2006
Last Update: November 02, 2007
Deactivation Date: May 21, 2019

Mailing Address

Po Box 6455

Tyler, TX 757116455

Phone: 9035942451

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.