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Organization

JOHN M WILSON MD P C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN M WILSON M.D. (MEDICAL DOCTOR)
(505) 878-9000
Entity
Organization

Contact information

Practice address
6100 SEAGULL ST NE, B-109, ALBUQUERQUE, NM 87109-2500
(505) 878-9000
(505) 878-8902
Mailing address
6100 SEAGULL ST NE, B-109, ALBUQUERQUE, NM 87109-2500
(505) 878-9000
(505) 878-8902

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
96-161
NM
305R00000X
Preferred Provider Organization
96-161
NM

Other

Enumeration date
04/19/2007
Last updated
09/11/2025
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