# DR. LORI L WILSON

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1679578249
- **Gender:** F
- **Credential:** DPM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171W00000X | Contractor | SC003555R | PA | — |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | SC003555R | PA | Yes |
| 213ES0131X | Foot Surgery Podiatrist | SC003555R | PA | — |
| 261QP1100X | Podiatric Clinic/Center | SC003555R | PA | — |

## Other

- **Enumeration date:** 06/20/2005
- **Last updated:** 06/16/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001214510003 | — | PA |