Individual
JUDITH H WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1100 HOLLENBACK LN, DEER LODGE, MT 59722
(406) 846-2212
Mailing address
1100 HOLLENBACK LN., DEER LODGE, MT 59722
(406) 846-2212
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
4610
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
28220
—
MT
01
—
92501
BCBS
MT
Enumeration date
07/06/2006
Last updated
09/08/2020
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