Individual
RALPH STANLEY WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 PROFESSIONAL BLVD, EVANSVILLE, IN 47714-8009
(812) 473-2060
(812) 473-0763
Mailing address
1020 PROFESSIONAL BLVD, EVANSVILLE, IN 47714-8009
(812) 473-2060
(812) 473-0763
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01022390
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000383763
ANTHEM
IN
01
—
00000383763
ANTHEM
KY
01
—
113394
HEALTHLINK
IN
01
—
113544
HEALTH ALLIANCE
IN
01
—
P00280947
RR MEDICARE
IN
Enumeration date
03/21/2006
Last updated
10/23/2007
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