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Individual
JEFFREY SCOTT WILSON
Active
Individual
JEFFREY SCOTT WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
ME 101963
FL
2086S0129X
Vascular Surgery Physician
Primary
ME101963
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000293800
—
FL
01
—
59056
BLUE CROSS BLUE SHIELD
FL
Enumeration date
03/29/2006
Last updated
12/09/2013
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