Individual
DR. MARK JOSEPH WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
655 BRANDON TOWN CENTER MALL, BRANDON, FL 33511-4770
(813) 681-1036
(813) 651-0718
Mailing address
5015 BELMONT RD, TAMPA, FL 33647-1319
(813) 681-1036
(813) 651-0718
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPC 1872
FL
Other
Enumeration date
06/28/2006
Last updated
04/15/2013
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