Individual
JEFFREY LEE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7600 FRANCE AVE S STE 5100, EDINA, MN 55435
(952) 893-1959
(952) 893-1954
Mailing address
7600 FRANCE AVE S STE 5100, EDINA, MN 55435-5924
(952) 893-1959
(952) 893-1954
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
42120
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150037C477
UCARE
MN
01
—
1547628
AMERICA'S PPO
MN
01
—
3200087
MEDICA
MN
05
—
351029800
—
MN
01
—
411774839A010
CHAMPUS
MN
01
—
56G59WI
BLUE CROSS BLUE SHIELD
MN
01
—
660003750
RR MEDICARE
MN
01
—
960081023350
PREFERRED ONE
MN
01
—
HP29582
HEALTHPARTNERS
MN
Enumeration date
06/09/2005
Last updated
11/18/2020
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