Individual
CONNIE MARIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1921 STONECIPHER BLVD, ADA, OK 74820
(580) 421-4570
Mailing address
1921 STONECIPHER BLVD, ADA, OK 74820
(580) 421-4570
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
3394
OK
207R00000X
Internal Medicine Physician
Primary
3394
OK
Other
Enumeration date
04/06/2006
Last updated
10/30/2025
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