Organization
JACK J WILSON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK J WILSON MD (PRES)
(407) 628-0853
Entity
Organization
Contact information
Practice address
2025 SUMMERLAND AVE, WINTER PARK, FL 32789-1453
(407) 628-0853
(407) 628-0853
Mailing address
2025 SUMMERLAND AVE, WINTER PARK, FL 32789-1453
(407) 628-0853
(407) 628-0853
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME 0058840
FL
Other
Enumeration date
07/04/2006
Last updated
06/07/2010
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