Organization
BENJAMIN R. WILSON, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN WILSON MD (PRESIDENT)
(503) 851-8908
Entity
Organization
Contact information
Practice address
465 COMMERCIAL ST NE STE 150, SALEM, OR 97301-3414
(503) 304-4358
(503) 304-4361
Mailing address
PO BOX 3275, SALEM, OR 97302-0275
(503) 851-8908
(503) 304-4361
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
15965-7
—
OR
Enumeration date
09/01/2009
Last updated
04/19/2024
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