Individual
LIBBY J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
280 RED COACH DR, SPRINGFIELD, OH 45503-1297
(937) 399-3010
(937) 399-3020
Mailing address
280 RED COACH DR, SPRINGFIELD, OH 45503-1297
(937) 399-3010
(937) 399-3020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-08-1991
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2498686
—
OH
Enumeration date
09/25/2006
Last updated
11/19/2008
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