Individual
DR. JACOB MICHAEL WILSON
Active
Individual
DR. JACOB MICHAEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
008704
GA
207X00000X
Orthopaedic Surgery Physician
Primary
65315
TN
207X00000X
Orthopaedic Surgery Physician
68800
MN
207X00000X
Orthopaedic Surgery Physician
76239
WI
Other
Enumeration date
04/01/2016
Last updated
10/13/2022
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