Individual
DR. SIDNEY MAURICE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6745 S SIWELL RD, SUITE 106, BYRAM, MS 39272-8700
(601) 373-0354
(601) 373-0321
Mailing address
6745 S SIWELL RD, SUITE 106, BYRAM, MS 39272-8700
(601) 373-0354
(601) 373-0321
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
568
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02229351
—
MS
Enumeration date
02/17/2007
Last updated
02/17/2011
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