Individual
CALEB WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4021 AVENUE B, SCOTTSBLUFF, NE 69361-4602
(308) 635-3711
Mailing address
4021 AVENUE B, SCOTTSBLUFF, NE 69361-4602
(308) 635-3711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A159522
CA
Other
Enumeration date
04/14/2017
Last updated
05/15/2023
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