Individual
MR. JON DARREN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3601 S 6TH AVE, TUCSON, AZ 85723-0001
(520) 629-6613
Mailing address
3601 S 6TH AVE, TUCSON, AZ 85723-0001
(520) 629-6613
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085004141
IL
363A00000X
Physician Assistant
2011040196
MO
363A00000X
Physician Assistant
Primary
5770
AZ
Other
Enumeration date
10/06/2008
Last updated
11/14/2015
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