# DONALD R. WILSON, M.D., INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790033959
- **Authorized official:** DR. DONALD RICHARD WILSON M.D. (PRESIDENT)
- **Authorized official phone:** (707) 965-2181

## Contact information

- **Practice address:** 715 LINDA FALLS TER, ANGWIN, CA 94508-9684
- **Practice address phone:** (707) 965-2181
- **Practice address fax:** (707) 965-3576
- **Mailing address:** PO BOX 714, ANGWIN, CA 94508-0714
- **Mailing address phone:** (707) 965-2181
- **Mailing address fax:** (707) 965-3576

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | A24934 | CA | Yes |

## Other

- **Enumeration date:** 08/20/2012
- **Last updated:** 08/20/2012