Individual
VIVIAN L WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12716 N.E. 36TH STREET, OKLAHOMA CITY, OK 73140
(405) 769-3301
(405) 769-9685
Mailing address
PO BOX 30589, 12716 N.E. 36TH STREET, MIDWEST CITY, OK 73140-3589
(405) 769-3301
(405) 769-9685
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
11902
OK
Other
Enumeration date
08/29/2006
Last updated
01/23/2026
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