Individual
CHRISTOPHER DALE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
611 ALCORN DR, CORINTH, MS 38834-9321
(662) 293-1440
(662) 293-4213
Mailing address
611 ALCORN DR, CORINTH, MS 38834-9321
(662) 293-1440
(662) 293-4213
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R879347
MS
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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