Organization
CONNIE M WILSON DO PC
Active
Other names
Wilson Loughridge
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONNIE M WILSON DO (OWNER / PRESIDENT)
(580) 504-5596
Entity
Organization
Contact information
Practice address
1005 15TH AVE NW, ARDMORE, OK 73401-1810
(580) 226-1010
(580) 226-1011
Mailing address
PO BOX 1987, ARDMORE, OK 73402-1987
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3394
OK
Other
Enumeration date
06/14/2011
Last updated
09/27/2011
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