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Individual

LUKE A WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 CARONDELET DR, KANSAS CITY, MO 64114-4673
(913) 599-6777
(913) 599-3955
Mailing address
8000 W 110TH ST STE 150, OVERLAND PARK, KS 66210-2382
(913) 599-6777
(913) 599-3955

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
2005014017
MO
2085R0202X
Diagnostic Radiology Physician
3914-320
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
207357609
MO
01
34908019
BLUE CROSS BLUE SHIELD
KS
Enumeration date
07/12/2006
Last updated
07/31/2025
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