Individual
MR. JARRED DOUGLAS WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SURFACE IDC
Contact information
Practice address
365 GONZALEZ BLVD, CAMP LEJEUNE, NC 28542
(910) 451-5846
Mailing address
365 GONZALEZ BLVD, CAMP LEJEUNE, NC 28542
(910) 451-5846
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
10/23/2015
Last updated
07/02/2025
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