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Individual
DR. ROGER W WILSON
Active
Individual
DR. ROGER W WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1341
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000149032
ANTHEM BC & BS
OH
01
—
1052235
AETNA
OH
01
—
421248625003
MEDICAL MUTUAL OF OH
OH
01
—
44-00336
UNITEDHEALTH CARE
OH
Enumeration date
11/08/2005
Last updated
07/08/2007
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