Organization
DR CONNIE M WILSON PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONNIE MARIE WILSON DO (PHYSICIAN OWNER)
(580) 504-8084
Entity
Organization
Contact information
Practice address
970 NORTHWEST BLVD, ARDMORE, OK 73401-1534
(580) 504-8084
(580) 657-3335
Mailing address
PO BOX 1987, ARDMORE, OK 73402-1987
(580) 504-8084
(580) 657-3335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
3394
OK
Other
Enumeration date
09/17/2012
Last updated
09/17/2012
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