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WILLIAM E WILSON MD
>> Family Medicine >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1508857764
Individual Registrant: WILLIAM E WILSON MD
Gender: M
Not Sole Proprietor
Gender: M
Not Sole Proprietor
Location and contact information for practice:
315 LANKFORD ST CLAY CITY, IN 47841-1008 US
Tel: 812-939-2126 Fax: 812-939-3414
Tel: 812-939-2126 Fax: 812-939-3414
Contact information for business:
PO BOX 2505 INDIANAPOLIS, IN 46206-2505 US
Tel: 812-238-7783 Fax: 812-238-4506
Tel: 812-238-7783 Fax: 812-238-4506
Registration Information:
NPI: 1508857764
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 207Q00000X | Allopathic & Osteopathic Physicians Family Medicine | IN | 01043986 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| RR MEDICARE | P00213807 | IN | 01 |
| 100369360 | IN | 05 |
