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Individual
SCOTT R WILSON
Active
Individual
SCOTT R WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
28853
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
19745
WELLMARK BCBS
IA
05
—
2071217
—
IA
Enumeration date
10/07/2005
Last updated
10/09/2025
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