Individual
DR. ALAN JOHN WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 S 14TH ST, HERRIN, IL 62948-3631
(618) 942-2171
(618) 351-4917
Mailing address
1239 E MAIN ST, CARBONDALE, IL 62901-3175
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036147913
IL
207P00000X
Emergency Medicine Physician
2011008025
MO
207Q00000X
Family Medicine Physician
Primary
MD202418
LA
Other
Enumeration date
03/07/2007
Last updated
01/30/2025
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