Individual
DR. LAURALEE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1919 W PARK DR, NORTH WILKESBORO, NC 28659-3564
(336) 651-2980
Mailing address
PO BOX 751803, CHARLOTTE, NC 28275-1803
(704) 384-7840
(704) 384-7830
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
200000668
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89127A2
—
NC
Enumeration date
04/04/2006
Last updated
02/19/2013
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