Individual
DR. WILLIAM P.D. WILSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2860 CHANNING WAY, SUITE 112, IDAHO FALLS, ID 83404-7531
(208) 524-4381
(208) 523-6477
Mailing address
2860 CHANNING WAY, SUITE 112, IDAHO FALLS, ID 83404-7531
(208) 524-4381
(208) 523-6477
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
M-5527
ID
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
M-5527
ID
Other
Enumeration date
08/27/2006
Last updated
02/20/2015
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