Individual
DR. IDA MAYS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1333 SURGICAL SERVICES WAY, KALISPELL, MT 59901-4844
(406) 751-5392
(406) 751-5406
Mailing address
325 9TH AVE # 359796, SEATTLE, WA 98104-2499
(206) 744-3564
(206) 744-8582
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD61288990
WA
208600000X
Surgery Physician
Primary
MED-PHYS-LIC-126760
MT
2086S0102X
Surgical Critical Care Physician
MED-PHYS-LIC-126760
MT
2086S0127X
Trauma Surgery Physician
MED-PHYS-LIC-126760
MT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/27/2017
Last updated
02/19/2024
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