Organization
TIMOTHY J. WILSON, D.O, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY J WILSON D.O (PRESIDENT)
(304) 242-1032
Entity
Organization
Contact information
Practice address
1132 NATIONAL RD, WHEELING, WV 26003-5704
(304) 242-1032
Mailing address
1132 NATIONAL RD, WHEELING, WV 26003-5704
(304) 242-1032
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2098
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2665272
—
OH
05
—
3810005848
—
WV
Enumeration date
06/19/2006
Last updated
12/27/2007
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