Individual
LAURA GRACE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-3049
(352) 627-9350
Mailing address
49 JESSE HILL JR DR SE, ATLANTA, GA 30303-3049
(404) 778-1415
(404) 778-1401
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
ME132997
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2014
Last updated
07/27/2020
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