Individual
DR. JOHN M. WILSON
Active
Individual
DR. JOHN M. WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101056617
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
186475
ANTHEM PROVIDER NUMBER
VA
01
—
2019602
CIGNA BEHAVIOR PROVIDER N
—
01
—
203639329001
TRICARE PROVIDER NUMBER
VA
01
—
239524
VALUE OPTIONS PROVIDER NU
—
01
—
O88170
SENTARA PROVIDER NUMBER
VA
Enumeration date
08/03/2005
Last updated
03/13/2008
Update your record
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