Individual
DR. DONALD ROBERT WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
117 E UNION ST, NEWARK, NY 14513-1503
(315) 331-7917
Mailing address
88 MATTHEW DR, FAIRPORT, NY 14450-9337
(585) 223-3412
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
003598
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000914282002
HEALTH NOW
NY
05
—
00468644
—
NY
01
—
010003598
BLUE CHOICE
NY
01
—
020003598
BLUE CROSS BLUE SHIELD
NY
01
—
101949CS
PREFERRED CARE
NY
Enumeration date
10/05/2006
Last updated
07/08/2007
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