Individual
JAMES CRAIG WILSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 GREENLEY RD, SONORA, CA 95370-5200
(209) 342-2300
(209) 524-4240
Mailing address
4301 NORTHSTAR WAY, MODESTO, CA 95356-9262
(209) 342-2300
(209) 524-4240
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A24429
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A244290
BLUE SHIELD
CA
05
—
00A244290
—
CA
Enumeration date
12/07/2005
Last updated
07/08/2007
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