Individual
DR. STEVEN M. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
519 STATE ST, NEW ALBANY, IN 47150-3620
(812) 948-0616
(812) 949-3447
Mailing address
519 STATE ST, NEW ALBANY, IN 47150-3620
(812) 948-0616
(812) 949-3447
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0954DT
KY
152W00000X
Optometrist
Primary
18001984A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042621
ANTHEM
KY
05
—
1056447
—
KY
05
—
200038300
—
IN
05
—
2433872000
—
KY
05
—
77340487
—
KY
Enumeration date
07/12/2005
Last updated
09/29/2020
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