Individual
TINA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
(210) 220-7961
Mailing address
1 JARRETT WHITE RD, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
DOS-2339
HI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/16/2020
Last updated
10/04/2022
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