Organization
ROGER L. WILSON, O.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER L. WILSON O.D. (PRESIDENT)
(904) 280-2021
Entity
Organization
Contact information
Practice address
110 SOLANA RD, PONTE VEDRA BEACH, FL 32082-2230
(904) 280-2021
(904) 280-2024
Mailing address
110 SOLANA RD, PONTE VEDRA BEACH, FL 32082-2230
(904) 280-2021
(904) 280-2024
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OP2569
FL
Other
Enumeration date
05/11/2008
Last updated
05/11/2008
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