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Individual

DR. JOHN R WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2900 12TH AVE N, SUITE 140W, BILLINGS, MT 59101-7506
(406) 238-6540
(406) 238-6599
Mailing address
2900 12TH AVE N, SUITE 140W, BILLINGS, MT 59101-7506
(406) 238-6540
(406) 238-6599

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
8411
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000091778
BLUECROSS BLUESHIELD
MT
05
108160
MT
05
114452900
WY
01
200033018
RR MEDICARE
MT
Enumeration date
08/19/2005
Last updated
04/29/2008
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