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Individual
DR. KEITH A WILSON
Active
Individual
DR. KEITH A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35-052784
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000126322
ANTHEM
OH
01
—
0095849000
MEDICAID
WV
05
—
0624695
—
OH
01
—
0800328
UNITED HEALTHCARE
OH
01
—
180011155
RAILROAD MEDICARE
OH
01
—
4096251
AETNA
OH
01
—
438220
KEYSTONE
OH
01
—
82799
QUALCHOICE
OH
01
—
Z52784
SUMMACARE
OH
Enumeration date
08/12/2005
Last updated
01/14/2025
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