Individual
DR. ISAIAH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 S UTICA AVE, SUITE 3074, TULSA, OK 74104-4012
(918) 579-7100
(918) 579-7110
Mailing address
1120 S UTICA AVE, SUITE 3074, TULSA, OK 74104-4012
(918) 579-7100
(918) 579-7110
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
30211
OK
208100000X
Physical Medicine & Rehabilitation Physician
4301095138
MI
Other
Enumeration date
03/27/2008
Last updated
09/23/2020
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