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Individual

DR. JAMES CORNELIUS WILSON III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
46 N MAIN ST, WEST BROOKFIELD, MA 01585-3232
(508) 867-8977
Mailing address
68 WARE ST, WEST BROOKFIELD, MA 01585-3136
(508) 867-8977

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
219183
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2096200
MA
Enumeration date
10/12/2005
Last updated
02/19/2016
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