Individual
DR. ROBERT LYON WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4201 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3410
(405) 632-4000
(405) 632-4073
Mailing address
4201 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3410
(405) 632-4000
(405) 632-4073
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
13185
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100095080A
—
OK
Enumeration date
12/08/2005
Last updated
07/11/2011
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