Individual
MICHAEL W WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
11601 S WESTERN AVE, OKLAHOMA CITY, OK 73170-5823
(405) 691-5208
(405) 378-0556
Mailing address
2777 NW 222ND ST, EDMOND, OK 73025-9087
(405) 659-7114
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3890
OK
Other
Enumeration date
01/11/2006
Last updated
01/25/2016
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