Individual
DR. STEVEN MICHAEL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2108 N PATTERSON ST, VALDOSTA, GA 31602-2947
(229) 244-3000
(229) 244-1934
Mailing address
PO BOX 3211, VALDOSTA, GA 31604-3211
(229) 244-3000
(229) 244-1934
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OP1564
FL
152W00000X
Optometrist
Primary
OPT000922
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00213342A
—
GA
Enumeration date
03/24/2006
Last updated
07/01/2021
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