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Organization
ROGER L. WILSON, O.D., P.A.
Active
Organization
ROGER L. WILSON, O.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER L. WILSON O.D. (PRESIDENT)
(904) 280-2021
Entity
Organization
Contact information
Practice address
110 SOLANA RD, PONTE VEDRA BEACH, FL 32082-2230
(904) 280-2021
(904) 280-2024
Mailing address
110 SOLANA RD, PONTE VEDRA BEACH, FL 32082-2230
(904) 280-2021
(904) 280-2024
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OP2569
FL
Other
Enumeration date
05/11/2008
Last updated
05/11/2008
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