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JEFFREY WHITESIDE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10229 W GREENFIELD AVE, WEST ALLIS, WI 53214
(414) 453-6330
(414) 453-6523
Mailing address
10229 W GREENFIELD AVE, WEST ALLIS, WI 53214
(414) 453-6330
(414) 453-6523

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
15620
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
11713
AMER BOARD OF PSYCH NEURO
05
31772200
WI
Enumeration date
08/27/2006
Last updated
08/17/2010
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