Individual
RICHARD W WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16611 S 40TH ST, SUITE 180, PHOENIX, AZ 85048
(480) 785-2100
(480) 785-2111
Mailing address
2545 W FRYE RD, SUITE 9, CHANDLER, AZ 85224-6273
(480) 505-4258
(480) 275-8346
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
28238
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
634320
—
AZ
Enumeration date
04/20/2006
Last updated
09/05/2018
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