Individual
MATTHEW JAMES WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1318
(502) 634-6767
Mailing address
3 AUDUBON PLAZA DR STE 340, LOUISVILLE, KY 40217-1319
(502) 634-6767
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
56990
KY
207P00000X
Emergency Medicine Physician
TP727
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2017
Last updated
06/17/2022
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