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Individual
KELLY EDWARD WILSON
Active
Individual
KELLY EDWARD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-37263
KS
208M00000X
Hospitalist Physician
57325
TN
208M00000X
Hospitalist Physician
Primary
ME149235
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2012
Last updated
05/24/2023
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