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Individual
THEODORE ERNEST WILSON
Active
Individual
THEODORE ERNEST WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
01079354A
IN
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
TP230
KY
208000000X
Pediatrics Physician
01079354A
IN
208000000X
Pediatrics Physician
P27658
MD
Other
Enumeration date
05/18/2012
Last updated
07/24/2026
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