Individual
DR. DAVID EARL WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9401 N OAK TRFY STE 100, KANSAS CITY, MO 64155-3393
(816) 436-1700
(816) 436-3133
Mailing address
9401 N OAK TRFY STE 100, KANSAS CITY, MO 64155-3393
(816) 436-1700
(816) 436-3133
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MDR4908
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04489010
BCBS OF KC INDIVIDUAL #
MO
01
—
110042554
RAILROAD MEDICARE
—
Enumeration date
01/25/2006
Last updated
07/16/2020
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