Organization
KENNETH M. WILSON, M.D., P.C.
Active
Other names
Hand Surgery of Oregon
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH MITCHELL WILSON M.D. (PRESIDENT)
(936) 777-2255
Entity
Organization
Contact information
Practice address
700 BELLEVUE ST SE STE 260, SALEM, OR 97301-3888
(503) 375-3636
(503) 375-3737
Mailing address
PO BOX 1168, CANBY, OR 97013-1168
(936) 777-2255
(503) 375-3737
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD16217
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
045336
—
OR
Enumeration date
07/30/2013
Last updated
07/30/2013
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