Individual
KELLY EDWARD WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 7TH ST N, NAPLES, FL 34102-5754
(239) 624-3997
(239) 624-8101
Mailing address
350 7TH ST N, NAPLES, FL 34102-5754
(239) 624-3997
(239) 624-8101
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-37263
KS
208M00000X
Hospitalist Physician
57325
TN
208M00000X
Hospitalist Physician
Primary
ME149235
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/26/2012
Last updated
05/24/2023
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