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Individual

DR. GREGORY LUIS WILSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1055 TEKULVE RD, BATESVILLE, IN 47006-8979
(812) 934-5347
(812) 932-2020
Mailing address
1055 TEKULVE RD, BATESVILLE, IN 47006-8979
(812) 934-5347
(812) 932-2020

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
IN18002615
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000090531
ANTHEM
IN
01
02880
SPECTERA
IN
01
0953810001
DMERC
IN
01
5083058
AETNA
IN
01
IN2615
EYEMED
IN
Enumeration date
09/22/2005
Last updated
07/08/2007
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