Individual
LUCAS HILLMAN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-2005
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-2005
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
52251
SC
2080P0202X
Pediatric Cardiology Physician
Primary
29776
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/27/2015
Last updated
03/28/2025
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