Individual
DR. BENJAMIN DAVID WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(575) 521-5385
Mailing address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(575) 521-5385
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
P5148
TX
207P00000X
Emergency Medicine Physician
Primary
U6831
TX
207Q00000X
Family Medicine Physician
RS2012-0325
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/09/2011
Last updated
11/04/2024
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