Individual
DR. RICHARD L WILSON JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3706 S MAIN ST, SUITE A, BLACKSBURG, VA 24060-7006
(540) 951-9000
(540) 951-7799
Mailing address
PO BOX 886, BLACKSBURG, VA 24063-0886
(540) 951-9000
(540) 951-7799
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
0101058886
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146535
ANTHEM
VA
Enumeration date
02/15/2006
Last updated
07/08/2007
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