Individual
MEGAN THERESA WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4401 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3413
(405) 636-7709
Mailing address
5717 NORMANDY TER, OKLAHOMA CITY, OK 73142-1816
(405) 343-9221
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
6074
OK
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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