# PRINCETON ORTHOPEDIC CLINIC, SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104014158
- **Authorized official:** DR. JAMES HOWARD WILSON MD MD (CEO)
- **Authorized official phone:** (309) 895-1052

## Contact information

- **Practice address:** 9291 IL HIGHWAY 40, BUDA, IL 61314-9451
- **Practice address phone:** (309) 895-1052
- **Mailing address:** 9291 IL HIGHWAY 40, BUDA, IL 61314-9451
- **Mailing address phone:** (309) 895-1052

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/03/2007
- **Last updated:** 10/03/2007