Organization
JAMES WILSON MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES HENRY WILSON MD (MD/OWNER)
(518) 512-4166
Entity
Organization
Contact information
Practice address
2500 POND VW, SUITE 204, CASTLETON, NY 12033-9750
(518) 512-4166
(518) 512-4170
Mailing address
2500 POND VW, SUITE 204, CASTLETON, NY 12033-9750
(518) 512-4166
(518) 512-4170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207773
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01820915
—
NY
01
—
207773
NYS LICENSE
NY
Enumeration date
04/23/2012
Last updated
04/23/2012
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